Fetal minitoring data were analyzed in 176 labors that developed ominous fetal heart rate deceleration patterns (FHRDP) during the two hours prior to delivery in an effort to identify how neonatal condition could be most accurately predicted. It was found that ominous FHRDP corresponded to a one-minute Apgar score of 6 or less in only 15.3% of cases. When patterns with fetal scalp blood pHs (FSBpH) of less than or equal to 7.20 (n = 18) were considered, 44.4% had an Apgar score of 6 or less. Mean Apgar scores for those neonates who had a pH of less than or equal to 7.20 were significantly less than the mean Apgar score of the control group (p less than 0.001 for all deceleration types). The result reveals that FSBpH has a better predictive value than FHRDP alone for neonatal depression. It is suggested that, as soon as ominous FHRDP occurs during labor, FSBpH be performed to assess not only fetal status but also to predict neonatal outcome.
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