SummaryFetal heart rate and uterine contractions were monitored simultaneously at the time of amniocentesis in 46 patients where the pregnancy was considered to be‘at risk’. The study was conducted to assess the fetal heart rate response to the additional stress of amniocentesis.The usual fetal heart rate response to the procedure is a transient tachycardia. This is more likely to occur when contractions are present or provoked. A nonreactive trace is more common when there are no contractions. A record of uterine contractions during the procedure is therefore necessary for evaluation. Decelerations of the fetal heart rate after amniocentesis indicate a fetus in jeopardy likely to develop fetal distress, either as a result of the procedure or in labour