Sinusoidal heart rate pattern and fetal distress secondary to severe anemia

A case of sinusoidal fetal heart rate (FHR) pattern with fetal anemia is described. The etiology of the pattern appears to have been fetal anemia from an umbilical cord knot, abruptio placentae and fetal asphyxia. The poor neonatal outcome in our case and a review of the literature suggest that a sinusoidal pattern is an ominous sign demanding complete evaluation of fetal well-being and often prompt obstetric intervention. The use of scalp capillary hematocrit is suggested.