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Fischer Score for Fetal Cardiotocography

Purpose: To evaluate fetal condition during labor using cardiotocography and Fischer's point score.

Description

Fischer developed a point score for evaluating fetal status during labor using cardiotocography. The fetal heart rate and changes relative to uterine contractions can help identify a fetus at risk, for whom an immediate Caesarean section may be indicated.


Recording:

(1) Sensors may be placed externally (prior to membrane rupture) or internally (after membrane rupture).

(2) The rate is recorded on a monitoring strip for at least 30 minutes.

 

Parameters:

(1) basal fetal heart rate

(2) fluctuations (bandwidth) in fetal heart rate

(3) number of missed beats

(4) accelerations associated with uterine contractions

(5) decelerations associated with uterine contractions

 

Parameter

Finding

Points

basal fetal heart rate

< 100 beats per minute

0

 

100 – 119 beats per minute

1

 

120 – 160 beats per minute

2

 

161 – 180 beats per minute

1

 

> 180 beats per minute

0

fluctuations

< 5

0

 

5 - 9

1

 

10 - 30

2

 

> 30

1

missed beats

0 or 1

0

 

2 – 6

1

 

> 6

2

accelerations

none

0

 

periodic

1

 

sporadic

2

decelerations

late

0

 

variable

1

 

sporadic, dip = 0

2

 

none

2

 

where:

• The table on page 15 in Rabe shows overlap in ranges for basal fetal heart rate (1 point for 160 - 180; 2 points for 120 - 160) and fluctuations (1 point for 5-10; 2 points for 10-30). I adjusted these in the table above so they would be discrete.

 

score =

= SUM(points for all 5 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 10

 

Score

Fetal Condition

8 – 10

good (physiologically)

5 – 7

doubtful prognosis

0 – 4

dangerous state

 


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Specialty

Objective

ICD-10