Perinatal observations in a high-risk population managed without intrapartum fetal pH studies

Intrapartum fetal scalp blood pH studies remain controversial in obstetrics. Electronic fetal monitoring, by contrast, has achieved nearly uniform acceptance. Controlled comparative studies from one institution are unlikely to provide adequate numbers. Intrapartum fetal monitoring is used consistently at our institution. Fetal health is assessed by monitoring criteria, and intervention occurs only for obstetric or monitoring indications. With the presumption that intrapartum compromise and its management will usually be reflected in early neonatal findings, three recent years of perinatal results in a predominantly high-risk population of over 7100 deliveries are reported. Comparisons are made to results of other similar populations managed elsewhere with and without pH studies. Absence of pH studies did not appear to result in extraordinary rates of stillbirth, operative intervention, or neonatal compromise. The data are offered for interest but cannot by themselves prove the lack of worth of a test not used.