More recent large-scale studies have instituted monitoring as soon as the patient is admitted in early labor and compared these results to historic controls. No reduction in cases of cerebral palsy has been documented in cases of preterm labor suggesting that at least in these cases, hypoxic insults may have occurred either prior to labor or after delivery. Although the subject is by no means resolved, the current data points towards a possible benefit of continuous electronic fetal monitoring in term fetuses if instituted early in labor. This definition is of no use in current practice, but still, the term fetal distress continues to be used. Figure A Fetal bradycardia occurring during an episode of uterine hypertonus.
Gradual resolution occurs after uterine hypertonus is treated with terbutalin.
Since most cases will resolve, a reasonable period of observation should be provided before proceeding with a cesarean section. Even in cases where delivery by cesarean section will be elected, waiting for resolution of the bradycardia may allow for delivery of a fetus less likely to be acidotic. Careful analysis of the situation may prevent unnecessary surgery. Changing maternal position, amnioinfusion, and beta-mimetics may resolve the situation or at least stabilize the patient in order to proceed with a cesarean section and produce a neonate less likely to be acidotic. Its presence implies severe fetal anemiaImply anemia, decreased oxygen carrying capacity and hypovolemia.