Short term variability of fetal heart rate during insulin-dependent diabetic pregnancies

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Abstract
The clinical significance of quantified short term variability of antepartal fetal heart rate (FHR) in prediction of [human] fetal distress in labor assessed in 120 insulin-dependent diabetic pregnancies. FHR was recorded by abdominal fetal ECG (aFECG), from which the differential indices (DI) describing the short term variability of FHR were analyzed by a microprocessor-based on-line method. The analysis was successful in 308 of 350 trials (87%). In 10 pregnancies, no acceptable aFECG was obtained. Fetal distress developed in 28 of the 110 pregnancies with successful FHR analysis. There were no intrauterine deaths in this series, but 2 newborn infants died (perinatal mortality 1.7%). Ninety-three pregnancies with FHR analyses within 1 wk of delivery were included in the assessment of the test. DI predicted 12 of the 17 cases of fetal distress (sensitivity 67%). Twelve of the 18 cases with a pathological DI developed fetal distress (predictive value 71%). DI were normal in 67 of the 73 pregnancies without fetal distress (specificity 92%). Risk of fetal distress after a pathological DI was 8.5 times that after normal DI (relative risk), which is highly significant.

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