SIGNIFICANCE OF FETAL HEART-RATE REACTIVITY WITH A POSITIVE OXYTOCIN CHALLENGE TEST

Abstract

Reviewed were 27 patients with positive OCT [oxytocin challenge test] who were subsequently allowed a trial of directly monitored labor. Of these, 19 patients (70%) developed FHR [fetal heart rate] signs of fetal distress and 8 (30%) tolerated labor without late decelerations. These patients were evaluated for signs of fetal reactivity (acceleration of the FHR associated with fetal movement or contractions) during the OCT. Those with a reactive pattern during the OCT (15 patients) uniformly had a good fetal outcome (unless there was birth trauma or premature delivery), but 8 of these 15 patients showed fetal distress during monitored labor. If the positive OCT was associated with a nonreactive baseline FHR recording, a trial of labor uniformly resulted in FHR signs of fetal distress. A patient with a nonreactive positive OCT was unlikely to tolerate subsequent labor without fetal distress.