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Late deceleration (LD) of fetal heart rate (FHR) was analyzed to clarify controversy LD record. The mechanical compression of pelvic large arteries by contracted uterus develops LD, and the pathologic fetal hypoxia is enhanced to developed pathologic outcome in frequently repeated LDs. 3 typical pattern LD resulted fully normal outcome of which Apgar was 9, while repeated LD for 50 minutes developed severe asphyxia of which Apgar was 3 and accompanied severe fetal brain damage, in addition, LD \ is defined after 15 minutes repetition. It is concluded from the facts that LD is ominous due to its frequent repetition but not by its late appearance pattern. Base on the facts, fetal damage is estimated by the hypoxia index (HI), which is the sum of durations (min) of FHR deceleration (transient bradycardia) divided by the lowest FHR (bpm) and multiplied by 100 to keep the integer. The hypoxia index was 25 or more in intrapartum fetal monitoring of all 6 cerebral palsy cases, while it was 24 or less in all 16 cases of no cerebral palsy. The probability to be error is zero, if it is said that cerebral palsy is prevented when the HI is 24 or less. *Correspondence to: Kazuo Maeda, Department of Obstetrics and Gynecology, Emeritus, Tottori university, Medical School, Postal: 3-125, Nadamachi, Yonago, Tottoriken, 683-0835 Japan, Phone and FAX: 81-859-22-6856; E-mail: maedak@mocha.ocn.ne.jp

Late deceleration and hypoxia index in fetal monitoring