Characteristics and management of intrapartum prolonged fetal bradycardia.

Twenty-five patients had intrapartum prolonged fetal bradycardia, defined as a drop of the fetal heart rate (FHR) by greater than or equal to 50 beats/min maintained for greater than or equal to 3 min; 10 were delivered by caesarean section and 15 vaginally. The only neonatal death occurred in the group delivered abdominally. Statistical analysis showed no difference in amplitude or duration of deceleration in the two groups but the 1 and 5 min Apgar scores were higher in the group delivered vaginally (P less than 0.01), whereas the onset of deceleration to delivery interval was shorter in the group delivered by caesarean section (p less than 0.005). Appropriate management of prolonged bradycardia is outlined and the characteristics of the FHR tracings are identified that are of prognostic value in determining whether or not immediate delivery is indicated.