Recent advances in genetics, immunology, hormonal chemistry, and bioelectronic technology, along with information obtained directly from the fetal environment, have improved our understanding of maternal-fetal relationships. As a result, timing of preterm induction of labor or cesarean section in high-risk pregnancies has become more critical. Despite these and concurrent advances in antibiotic therapy, acid-base balance, and respiratory care, the perinatal mortality has remained high and there has been little substantive improvement over the past decade in the incidence of neurologic deficiency in children.1,2 Appreciable evidence suggests that these disturbing statistics are related in part to unrecognized asphyxial and traumatic insults to the fetus during pregnancy, labor, and the neonatal period.3-6 It is generally agreed that improving these results will require even better definition of the condition of the individual fetus under consideration.
Deficiency of definition is nowhere more apparent than in the evaluation of the fetus during labor.