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The Significance of Prelabour Type 11 .Deceleration of Fetal Heart Rate in Relation to Braxton-Hicks Contractions
Abstract
During prelabour cardiotocography on 450 high risk antenatal patients, painless uterine contractions (BraxtonHicks) were recorded in 4 patients, who also showed a type 11 deceleration pattern. Two fetuses died and 2 were saved. In the 2 who died there was a delay of more than 12 hours between first observation and delivery, while in the 2 who were saved, immediate Caesarean section was performed. It is suggested that the sign of late deceleration in relation to Braxton-Hicks contractions is a preterminal manifestation of acute-on-chronic fetal distress, and the appropriate management should be immediate Caesarean section, whatever the gestation. Antenatal cardiotocography might therefore have a place in the assessment of the 'very small for gestational age fetus and an irritable uterus. This approach could ensure survival but not necessarily quality.
