Intrapartum management of category II fetal heart rate tracings: Towards standardization of care

Steven L. Clark, Michael P. Nageotte, Thomas J. Garite, Roger K. Freeman, David A. Miller, Kathleen R. Simpson, Michael A. Belfort, Gary A. Dildy, Julian T. Parer, Richard L. Berkowitz, Mary D'Alton, Dwight J. Rouse, Larry C. Gilstrap, Anthony M. Vintzileos, J. Peter Van Dorsten, Frank H. Boehm, Lisa A. Miller, Gary D.V. Hankins

Research output: Contribution to journalArticlepeer-review

92 Scopus citations


There is currently no standard national approach to the management of category II fetal heart rate (FHR) patterns, yet such patterns occur in the majority of fetuses in labor. Under such circumstances, it would be difficult to demonstrate the clinical efficacy of FHR monitoring even if this technique had immense intrinsic value, since there has never been a standard hypothesis to test dealing with interpretation and management of these abnormal patterns. We present an algorithm for the management of category II FHR patterns that reflects a synthesis of available evidence and current scientific thought. Use of this algorithm represents one way for the clinician to comply with the standard of care, and may enhance our overall ability to define the benefits of intrapartum FHR monitoring.

Original languageEnglish (US)
Pages (from-to)89-97
Number of pages9
JournalAmerican journal of obstetrics and gynecology
Issue number2
StatePublished - Aug 2013


  • fetal heart rate monitoring
  • neonatal encephalopathy
  • patient safety

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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