Fetal Distress

In order to obtain a fetal EKG, a presenting fetal part must be available for lead placement. Normal HR is 120-160 with 5-25 beats/min of beat-to-beat variability. Note that maternal opiates, atropine, or anesthetic agents can reduce beat-to-beat variability. Two types of decelerations are problematic – late (starting 10-30 seconds after contraction onset), which represent uteroplacental insufficiency, and variable, due to cord compression but which are usually benign (but are worrisome if lasting > 30 seconds or accompanied by HR < 70).


  • < 7.0: fetal depression
  • 7-7.2: acidosis
  • 7.2-7.25: “pre-acidosis”
  • > 7.25: normal

pO2: never exceeds 60 mm Hg
SpO2: should always exceed 30%
HR: 120-160 (5-25 beats/min fluctuation, less with opiates, atropine, or anesthetic agents)