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May 15, 1972

Fetal Heart Rate Patterns

Author Affiliations

Stanford Univ Med Center Stanford, Calif

JAMA. 1972;220(7):1015. doi:10.1001/jama.1972.03200070103027

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To the Editor.—  After reviewing fetal heart rate recordings of more than 1,750 parturients in late labor and using the concepts of ominous deceleration fetal heart patterns, our accuracy in prediction of low Apgar scores was remarkably close to that described by Schrifton and Dame (219:1322,1972). Mainly that we diagnosed 4 1/2 times as many fetuses in distress as proved to be so, as judged by the newborn's overall condition and its five-minute Apgar score. Based on this experience, we have ceased to use the deceleration pattern concept in late labor as the sole basis for diagnosis of fetal distress since these false diagnoses led to an excessive number of difficult operative deliveries. Unless Dr. Schrifton is able to restrain himself and his associates from taking some form of heroic action when abnormal heart patterns appear in late labor, I think it is argumentive whether the type of fetal