Fetal heart rate issues; C-section to prevent cerebral palsy: Results may be a wash. (Obstetrics).

VAIL, COLO. -- Performing cesarean section for abnormal fetal heart rate patterns in an effort to prevent cerebral palsy is likely to cause at least as many bad outcomes as it prevents, Dr. Gary D.V. Hankins said at a conference on obstetrics and gynecology sponsored by the University of Colorado.

He cited a 1996 study by Dr. Karin B. Nelson of the National Institute of Neurological Disorders and Stroke and her associates, who analyzed more than 155,000 births in four California counties during the mid-1980s. In this analysis, only two types of abnormal fetal heart rate patterns proved significantly related to the development of moderate or severe cerebral palsy: multiple late decelerations (odds ratio 3.9) and decreased beat-to-beat heart rate variability (odds ratio 2.7).

A key finding in this large case-control study was that only 0.19% of all singleton children with a birth weight of at least 2,500 g who survived to age 3 years and who had either of these nonreassuring fetal heart rate patterns turned out to have moderate to severe cerebral palsy; That means the false-positive rate for these abnormal fetal heart ...