Introduction

• Fetal morbidity and mortality can occur as a consequence of labor. A number of tests have been developed to assess fetus wellbeing (Figure 65.1).
  
• Attention has focused on hypoxic ischemic encephalopathy (HIE) as a marker of birth asphyxia and a predictor of long-term outcome. HIE is a clinical condition that develops within the first hours or days of life. It is characterized by abnormalities of tone and feeding, alterations in consciousness, and convulsions. In order to attribute such a state to birth asphyxia, the following four criteria must all be fulfilled:

• At most, only 15% of cerebral palsy and learning disability can be attributed to HIE.

Non-stress test (NST) or fetal cardiotocography (CTG)

A fetal scalp electrode for the continuous monitoring of the fetal heart rate during labor was introduced by Hon and Lee in 1963. A year later, Doppler technology made external fetal heart analysis possible. Continuous intrapartum CTG is now recommended for all high-risk pregnancies and is commonly used in low-risk pregnancies too.