Sawtooth fetal heart rate pattern due to in utero fetal central nervous system injury

Published:December 07, 2015DOI:
      We present 3 cases of documented central nervous system (CNS) injury with a characteristic fetal heart rate (FHR) sawtooth-like pattern. In the first case, there was category I fetal heart tracing during labor, which was followed by a sudden onset of fetal tachycardia, unstable and indeterminate baseline, and episodes of a sawtooth FHR pattern (Figure 1).
      Figure thumbnail gr1
      Figure 1Sawtooth pattern tracings
      A, Sudden onset of fetal tachycardia with sawtooth pattern. B, Sawtooth pattern with unstable baseline.
      Andrikopoulou & Vintzileos. Sawtooth pattern and fetal central nervous system injury. Am J Obstet Gynecol 2016.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Obstetrics & Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Modanlou H.D.
        • Murata Y.
        Sinusoidal heart rate pattern: reappraisal of its definition and clinical significance.
        J Obstet Gynaecol Res. 2004; 30: 169-180
        • Jonsson M.
        • Agren J.
        • Norden-Lindeberg Ohlin A.
        • Hanson U.
        Neonatal encephalopathy and the association to asphyxia in labor.
        Am J Obstet Gynecol. 2014; 211: 667.e1-667.e8
        • Sabiani L.
        • Le Du R.
        • Loundou A.
        • et al.
        Intra- and interobserver agreement among obstetric experts in court regarding the review of abnormal fetal heart rate tracings and obstetrical management.
        Am J Obstet Gynecol. 2015; 213: 856.e1-856.e8
        • Clark S.L.
        • Meyers J.A.
        • Frye D.K.
        • Garthwaite T.
        • Lee A.J.
        • Perlin J.B.
        Recognition and response to electronic fetal heart rate patterns: impact on newborn outcomes and primary cesarean delivery rate in women undergoing induction of labor.
        Am J Obstet Gynecol. 2015; 212: 494.e1-494.e6

      Linked Article