Maternal heart rate mistaken for fetal heart rate during del
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Misidentification of fetal and maternal heart rate is not an acceptable mistake. Published in the Journal of Clinical Gynecology and Obstetrics, the authors present here a case of maternal heart rate mistaken for the fetal heart rate during delivery in our hospital. In this case, the neonatal short outcomes were very poor contrary to the prediction based on the findings of heart rate tracings.

A 28-year-old woman, gravida 1, para 0, whose antenatal care had been uneventful, was admitted with the onset of labor pains at 37 weeks’ gestation. At admission, her heart rate was 88 bpm. During the first stage of delivery, fetal heart rate tracings showed reassuring patterns. The baseline of the fetal heart rate was 130 - 140 bpm.

She was transported to the delivery room when the cervix was fully dilated. During the second stage of delivery, fetal heart rate tracings seemed to be the baseline of 110 - 120 bpm with variability and the presence of recurrent mild variable decelerations.

Vacuum-extraction was selected due to the occiput posterior position of the fetal head. During the two-time extractions shown with the closed squares in Figure 1B, the heart rate increased to 110 bpm. The neonate was a male weighing 2,696 g (appropriate for gestational age) with heart rate of less than 100 bpm and no spontaneous respiration requiring neonatal cardiopulmonary resuscitation with artificial respiration.

The umbilical arterial pH was 6.776. After the fetal delivery, the heart beats were able to be detected at the same position of the maternal abdomen.

The neonate was admitted to the neonatal intensive care unit due to the respiratory and circulatory distress. Fortunately, he has now grown to a healthy boy of 1.5 years old without any problems.

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