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December 7, 1963

When is the Fetus Dead?

JAMA. 1963;186(10):926-928. doi:10.1001/jama.1963.63710100010013c

SEVERAL REPORTS have appeared in the literature dealing with rapid and variable fetal heart rate in the prepartal patient. The majority of these reports1-5 have referred to liveborn infants, who at sometime during their fetal stage presented, either by ausculatory or electrocardiographic methods, rapid and variable rhythms which converted spontaneously in pregnancy or remained unchanged and disappeared in the neonatal period. This report encompasses four patients in whom there was evidence of fetal heart electrical activity after clinical fetal death had occurred. Clinical death is defined in this study as lack of movements perceived by the mother or absence of fetal heart tones by auscultation.

Methods  Patient preparation consisted of emptying the bladder and thoroughly cleansing the skin beneath the electrode areas with acetone. Suction type electrodes were used on the abdomen and a silver plate electrode, on the right thigh for a ground. All studies were performed with