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Updated: Aug 17, 2025
12:17
The 4-vessel Sampling Approach to Integrative Studies of Human Placental Physiology In Vivo
Published on: August 2, 2017
10.7K
Sporadic accelerations during labor strongly indicate normal pH, whereas periodic accelerations do not: a
Frida Ekengård1, Monika Cardell1, Andreas Herbst1
1Department of Obstetrics and Gynecology, Skåne University Hospital, Institution of Clinical Sciences Lund University, Lund, Sweden.
Summary
Sporadic fetal heart rate accelerations during labor are strongly linked to a lower risk of acidemia at birth. However, their absence doesn't always mean a fetus is healthy, as they can be missing in healthy newborns.
Area of Science:
- Obstetrics and Gynecology
- Fetal Monitoring
- Neonatal Health
Background:
- Fetal heart rate (FHR) monitoring is crucial for assessing fetal well-being during labor.
- Understanding FHR patterns, specifically accelerations, can help predict adverse neonatal outcomes like acidemia.
Purpose of the Study:
- To investigate the association between sporadic and periodic FHR accelerations during labor and the occurrence of acidemia at birth.
Main Methods:
- A case-control study was conducted involving 364 neonates with acidemia and 731 controls.
- FHR patterns from the last 30-60 minutes of labor were analyzed using cardiotocography.
- Odds ratios (OR) were calculated to determine the risk of acidemia associated with FHR accelerations.
Main Results:
- The presence of two or more sporadic accelerations during labor was associated with a significantly lower risk of acidemia (OR 0.05-0.09).
- Even with normal FHR variability, fewer than two sporadic accelerations increased the risk of acidemia (OR 10.3).
- Periodic accelerations showed a weak, non-significant association with reduced acidemia risk in the second stage of labor.
Conclusions:
- Sporadic accelerations are a strong indicator of a low probability of fetal acidosis.
- The absence of sporadic accelerations does not entirely rule out normal fetal pH, as they can be absent in up to 40% of healthy fetuses.
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