The sinusoidal heart rate (SHR) pattern on the fetal cardiotocogram can be seen with a number of conditions, some pathologic and some benign


Diagnosis of benign SHR:

(1) Exclusion of the pathologic conditions associated with true SHR.

(2) There is evidence of heart rate accelerations prior to onset of the SHR.

(3) One or more of the following is noted:

(3a) The fetus is showing rhythmic movements such as sucking.

(3b) The onset was preceded by a dose of an opiate/narcotic or other drug.

(3c) The fetus is asleep.


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