NICHD fetal heart rate category (I, II, III)

Sorts a fetal heart rate tracing into the NICHD three-tier system.

Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.

Example

Baseline fetal heart rate
140 beats per minute
Baseline variability
Minimal (detectable, 5 beats per minute or fewer)
Late decelerations
Recurrent, with half or more of the contractions
Variable decelerations
Absent
Sinusoidal pattern
Absent

Result: Category II, because minimal variability is not absent variability

The tool opens with these values already filled in. Replace them with your own.

What the result means

Category I
All of: baseline 110 to 160 beats per minute, moderate variability, late decelerations absent, variable decelerations absent.
Category II
Every tracing that is neither Category I nor Category III.
Category III
Absent variability with recurrent late decelerations, recurrent variable decelerations or bradycardia; or a sinusoidal pattern.
Minimal is not absent
Category III needs absent variability. Minimal variability with recurrent late decelerations is Category II.
Category II is a residual
Not a middle severity. It covers an enormous range, most tracings fall in it, and it calls for evaluation and continued surveillance.
What it is not
A point-in-time description, not a prediction. None of the three categories is a management algorithm.

What you enter

  • Baseline fetal heart rate
  • Baseline variability
  • Late decelerations
  • Variable decelerations
  • Sinusoidal pattern (Category III on its own)
How this is calculated

Macones GA, Hankins GDV, Spong CY, Hauth J, Moore T. The 2008 National Institute of Child Health and Human Development workshop report on electronic fetal monitoring. Obstet Gynecol. 2008;112(3):661-666. Read the source ↗

A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.

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Built by Clay Good. Source on GitHub.