[Value of the Hammacher score and fetal blood analysis in subpartal monitoring of the child].

Although it has been documented in many studies that optimal monitoring of the fetus during labor is only achieved through a combination of cardiotocography (CTG) and fetal blood analysis, up to now no uniform guidelines exist as to when fetal blood analysis should be performed. Furthermore, there are still many obstetricians who decide on their delivery procedure entirely on the basis of CTG. We have therefore examined the question of how accurately intrauterine risk situations of the fetus can be recognized in individual cases by using the Hammacher score only from particular CTG patterns. The data from 407 patients formed the statistical basis. All these patients had been delivered between January and September 1979 at the Department of Obstetrics at the Women's Hospital in Berlin-Neukölln. In all cases, at least one fetal blood analysis had been performed on account of a suspicious CTG during the course of labor. All actual pH values were combined with the Hammacher score of the corresponding 30-min-interval, and in addition we recorded the CTG patterns seen. We observed that the CTG was at least suspicious (greater than or equal to 3 points) in 79,3%, while the fetal blood analyses performed immediately afterwards were normal in 78,1%; only in 11,7% it was reduced to 7,29-7,25 and in 10,2% it was less than or equal to 7,24 (incl. 3,9% less than or equal to 7,19). The probability that a high score was associated with a reduced pH increased from 2% at 0-2 points, to 26,3% at greater than or equal to 5 points.(ABSTRACT TRUNCATED AT 250 WORDS)