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Constant observation of fetal heart tones, especially in second stage labor, is generally accepted as fundamental in the proper conduct of labor.
When any portion of the scalp becomes visible in cephalic delivery, whether spontaneous or instrumental, I find the capillary circulation in the scalp a useful index of the presence and quality of the fetal circulation. Intermittent finger pressure with the consequent blanching and more or less rapid return of color affords a reliable criterion of the condition of the fetal heart. This sign, as far as I am aware, has not been described.
The scalp is usually quite wrinkled, covered with mucus and sometimes very hairy. Virgorous wiping, however, exposes the skin and reveals the capillary color change plainly. This is true even in the presence of a marked caput succedaneum.
The control of the fetal heart tones has been made easy by the use of the head stethoscope, but
Baer JL. AN AID TO DETERMINATION OF CONDITION OF THE FETAL HEART DURING LABOR. JAMA. 1929;92(26):2169. doi:10.1001/jama.1929.92700520002007c
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