About four million out of 120 million infants have birth asphyxia each year. Almost a million of these newborns are not successfully resuscitated. Changes in fetal heart rate precede brain injury and can be monitored. Applying some tests to women who are admitted to hospital for labour may help to identify fetal distress and allow timely and effective intervention such as caesarian delivery to prevent poor newborn outcomes. A fetal admission test may consist of monitoring the fetal heart for 20 minutes using a Doppler ultrasound transducer on the mother's abdomen (cardiotocography), uterine contractions, sound-provoked fetal movement, fetal breathing and estimation of amniotic fluid volume observed using real-time ultrasonography.
This review identified one randomised controlled study (involving 883 women) at 26 to 42 weeks' gestation and in early labour who were admitted to a tertiary hospital in USA (between July 1992 and January 1993). Measuring the amount of amniotic fluid when women were admitted did not improve infant outcomes but increased/doubled the caesarean section rate for fetal distress. The use of artificial oxytocin for augmentation of labour was also higher in the group of women who received the test than for those that did not. Because of the limited evidence (one study with a small sample size), we cannot make a meaningful conclusion or recommendations. More studies are needed.