Editorials

Deaths related to intrapartum asphyxia

BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7132.640 (Published 28 February 1998) Cite this as: BMJ 1998;316:640

Largely unexplained but probably preventable

  1. John A D Spencer, Consultant obstetrician and gynaecologist
  1. Northwick Park Hospital, Harrow, Middlesex HA1 3UJ

    Paper p 657

    Fetal death in labour is extremely rare. Although the total fetal death (stillbirth) rate has more than halved over the past 30 years, and is now about 5.5 per 1000 total births, the rate of intrapartum fetal death in babies above 1500 g is only 0.3 per 1000 total births. 1 2 Hypoxia is thought to be a factor in 90% of intrapartum deaths,2 and much of the reduction has been credited to continuous fetal heart rate monitoring, introduced into clinical practice about 30 years ago. Use of continuous fetal heart rate monitoring was soon found to be associated with significant falls in perinatal mortality, 3 4 and further evidence for an inverse association between the level of perinatal technology and the incidence of intrapartum fetal death came from the 1980 American national fetal mortality survey.5 Interestingly, the Dublin randomised controlled trial of fetal heart rate monitoring in …

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