[Maternal and fetal monitoring during labor]

Abstract

By use of cardiotocography, as screening method, and by fetal acid-base status estimation, it is possible, nowdays, to assess fetal oxygenation during every labor, allowing that way to recognize jeopardized fetus, and to undertake termination of labor on time. Fetal intrapartal mortality in Croatia has been declining for years. In 1985 fetal intrapartal mortality was 1.2%, in 1988 1.0% and in 1990 only 0.6%. At the Department of Obstetrics and Gynecology School of Medicine University of Zagreb fetal intrapartal mortality dropped from 3.3% in period from 1963 to 1967 to 0.6% in 1990. Increase in proportion of caesarean section deliveries, as well as increase in number of CTG equipments on our disposal is roughly parallel to this decline in intrapartal and perinatal mortality. In 1972 in only 4% of maternity hospitals there were more than 6% caesarean section deliveries, whereas in 1990 even in 26% of them the proportion of caesarean section deliveries exceeded 10%. In 1985 we were in need for 29 CTG equipments, and in 1990 for only 19. The decrease in perinatal, intrapartal and early neonatal mortality must be put in connection with increase in proportion of caesarean section deliveries and with increase in CTG's on disposal. On the contrary, fetal mortality during pregnancy has not changed for years and is between 4.7 and 5.7%. In spite of clearly improved perinatal outcome, this points to still not adequate antenatal surveillance with inadequate screening of high risk pregnancies.