Fetal activity acceleration during early labor.

Abstract

Altogether 59 women (53 normal and 6 high-risk pregnancies) underwent a fetal activity acceleration determination (FAD) during the first stage of labor. 52 FAD were considered reactive, while 5 were non-reactive and 2 technically inadequate. Four of the 5 fetuses with a non-reactive FAD showed signs of fetal compromise during labor and 1 died intra-uterinely. There were significantly more normal births and non-compromised fetuses in the FAD reactive group than in the non-reactive (p less than 0.002, chi 2-test), while there were significantly more acute cesarean sections in the non-reactive group (p less than 0.001, chi 2-test). Of the 12 vacuum extractions (all in the FAD reactive group) 4 were performed because of prolonged 2nd stage and 8 because of suspected because of prolonged 2nd stage and 8 because of suspected intra-uterine asphyxia, but all infants did well after delivery, and the umbilical arterial pH was in all cases above 7.15. It is concluded that when a FAD test is reactive in the first stage of labor, one can expect a positive outcome of the birth, whereas a non-reactive test arouses suspicion of fetal compromise and implies that one must carefully monitor the progress of the birth so that the fetus can be delivered promptly if any sign of late decelerations should appear. A reactive FAD is, on the other hand, rather reassuring for the fetal state.