Dr. Chapa’s OBGYN Clinical Pearls FHT Baseline Change (110-160) in Labor: Danger, or Disregard?
Dec 27, 2025
The podcast dives into the complexities of fetal heart rate (FHR) classification, particularly concerning baseline shifts during labor. It explores whether minor shifts within the normal range are concerning, addressing listener questions about 'zigzag' patterns. Dr. Chapa discusses potential causes for tachycardia and the significance of baselines in labor outcomes. With insights from recent studies, he emphasizes when to monitor and when to act, providing clinicians with practical guidance for navigating FHR variations.
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Consider IAI Without Maternal Fever
- Suspect intra-amniotic infection (IAI) when fetal tachycardia occurs even if maternal fever is absent.
- Evaluate for foul-smelling fluid, uterine tenderness, and other signs and treat promptly to avoid sepsis.
Manage Baseline Shifts Within Normal Range
- If the fetal heart rate baseline shifts within 110–160 and variability remains normal, continue routine management and document the change.
- Only escalate evaluation when the baseline crosses 160 or other clinical signs (fever, foul fluid, uterine tenderness) appear.
Use 10 Minutes To Define Baseline Change
- Define a true baseline change only after a sustained shift of at least 10 minutes.
- Treat shorter elevations as accelerations (A cells), not baseline changes, to avoid overcalling problems.