CLINICAL-EXPERIENCE WITH ANTEPARTUM COMPUTERIZED FETAL HEART-RATE MONITORING

Antepartum cardiotocography suffers from multiple limitations such as false positives and poor inter- and intraobserver reliability. An objective reproducible analysis might help reduce the magnitude of these problems. We report on a two and one-half year experience using the System 8000, a computerized fetal heart rate program for antenatal assessment. Three thousand and six tests were performed on 1000 women. The case selection was based upon the presence of risk factors and results of Doppler velocimetry studies. There were 93% normal, 6.9% questionable, and 0.4% abnormal results. Of those having questionable tests, the repeat test was normal in 70%. When corrected for congenital anomalies the stillbirth rate was 2/1000 births comparable to results from the larger studies previously published. The computer eliminates inter- and intraobserver error, eliminates excess testing in a normal population, and the data gathered provide a new approach to antenatal heart rate assessment.