A SIX‐POINT SCORING SYSTEM FOR ANTENATAL CARDIOTOCOGRAPHS

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Abstract
Summary: A six‐point scoring system for antenatal cardiotocography based upon baseline fetal heart rate (FHR) and FHR response to fetal movements and Braxton‐Hicks contractions has been described and tested in 89 patients. The ‘six‐point score’ obtained within 24 hours of delivery or death of the fetus (D—1) was shown to be strongly associated both with the one‐minute Apgar score and the nutritional status of the infant as reflected by centile birth weight. In 21 patients whose D—1 ‘six‐point score’ was 4 or less, analysis of the cardiotocographs performed on the previous day (D—2) showed that 14 infants already showed evidence of hypoxia. In the remaining seven patients, however, the previous day's six‐point score had been normal (5 or 6); in six of these patients a persistently low daily fetal movement count or placental abruption led to repeat cardiotocography. Hypoxia affected the three components of the score in a progressive manner. Firstly there were alterations in the response of the FHR to Braxton‐Hicks contractions followed by changes in the FHR response to fetal movements. Finally, fetal movements ceased and baseline FHR changes occurred mainly in the form of a tachycardia. The method of scoring was simple to use and could standardize reporting.

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