A SIX-POINT SCORING SYSTEM FOR ANTENATAL CARDIOTOCOGRAPHS

Summary

A six-point scoring system for antenatal cardiotocography based upon baseline fetal heart rate (FHR) and FHR response to fetal movements and Braxton-Hicks contractions has been described and tested in 89 patients. The ‘six-point score’ obtained within 24 hours of delivery or death of the fetus (D—1) was shown to be strongly associated both with the one-minute Apgar score and the nutritional status of the infant as reflected by centile birth weight. In 21 patients whose D—1 ‘six-point score’ was 4 or less, analysis of the cardiotocographs performed on the previous day (D—2) showed that 14 infants already showed evidence of hypoxia. In the remaining seven patients, however, the previous day's six-point score had been normal (5 or 6); in six of these patients a persistently low daily fetal movement count or placental abruption led to repeat cardiotocography. Hypoxia affected the three components of the score in a progressive manner. Firstly there were alterations in the response of the FHR to Braxton-Hicks contractions followed by changes in the FHR response to fetal movements. Finally, fetal movements ceased and baseline FHR changes occurred mainly in the form of a tachycardia. The method of scoring was simple to use and could standardize reporting.