Value of a screening fetal heart rate tracing in the latent phase of labor

We studied the value of a screening fetal heart rate (FHR) tracing obtained on 405 women in the latent phase of labor on presentation to the labor-and-delivery suite. All pregnancies were at term and had a cephalic presentation. Thirty-two women in the sample studied underwent a cesarean section for fetal distress. Using that end point, a screening FHR tracing in the admitting room had a sensitivity of 57%, specificity of 98%, positive predictive value of 75% and overall efficiency of 95%. One- and five-minute Apgar scores and thick meconium staining of the amniotic fluid were also examined. While no statistically significant differences were found (P less than .2 for Apgar score and less than .06 for meconium), there was a trend that might have been significant if more women had been studied. A screening FHR tracing on all women at term in the latent phase of labor will identify the majority of those who will develop fetal distress in labor. Women with an abnormal screening tracing should be admitted to the hospital and the fetal status evaluated further.