Fetal distress in term pregnancies

A diagnosis of fetal distress was made in 75 term obstetrical patients from a population of 3,972 term deliveries. Twenty-three percent of the infants were scored 6 or less on the 5-minute Apgar rating. One or more determinations of fetal scalp pH were available in 27 of these patients. The scalp pH improved the accuracy of the diagnosis of fetal distress modestly. Follow-up evaluation to at least 1 month of age was available in 75% of the infants. Six infants were not neurologically normal; in four of them this was of major importance, and in the other two it was of minor importance. In one, the condition was almost certainly unrelated to prenatal or perinatal factors, whereas in the other five, evidence of chronic fetal asphyxia as well as perinatal asphyxia was elicited. An additional 10 term infants with a 5-minute Apgar score of 6 or less had entirely normal electronic fetal monitoring tracings.