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The etiology of sinusoidal fetal heart rate (FHR) patterns is diverse and consequently they ave been associated with poor as well as normal fetal outcome. Four patients who demonstrated sinusoidal FHR patterns are reported, and the factors associated with these patterns and their effect on fetal outcome are discussed. Three of the babies were delivered by emergency cesarean section and were markedly depressed at birth. Two of the infants died and the third required prolong hospitalization. The fourth baby was delivered vaginally and had a normal outcome. The possible pathophysiology is discussed and recommendations are made for the management of this FHR pattern.
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