Probing the Fetal Cardiac Signal for Antecedents of Brain Injury

Obstetric care providers and researchers have long relied on analysis of the fetal heart rate tracing for insight into the fetal neurologic status. Although a normal fetal heart rate tracing does provide reassurance of intact neurologic function, an abnormal pattern is a very poor predictor of newborn brain injury. Indeed, if the clinical end point of interest is cerebral palsy, a non-reassuring fetal heart rate tracing has a 99% false positive rate. More recent analyses of fetal heart rate variability and fetal ECG waveforms, however, hold promise for improved diagnostic accuracy.