Abstract：Objective To explore the value of detection of hypoxia-inducible factor-1α (HIF-1α) level in maternal blood and fetal heart rate（FHR）monitoring patterns for fetal distress. Methods Ninety five patients with fetal distress (fetal distress group) and 40 healthy pregnant women (control group) were involved in this study. The levels of serum HIF-1α were measured. The fetal heart rate monitoring and the newborn Aparg´s scores were assessed. Results The levels of HIF-1α in maternal blood in fetal distress group were markedly higher than that in control group (105.73±31.12 vs 41.48±18.91 pg/L). In fetal distress group, as for HIF-1α levels in maternal blood, the fetal heart monitoring positive was 138.98±30.56 pg/L, the suspicious person was 94.21±28.93 pg/L, they were all significantly higher than that in the control group（P<0.01）. The fetal heart monitoring negative was 47.34±18.76pg/L. There was no significant difference between the fetal heart monitoring negative and the control group（P>0.05）. A significant difference was found in three groups with the fetal distress（P<0.05）. The level of HIF-1α in maternal blood was negative correlated with newborn Aparg´s score. Conclusion The level of HIF-1α in maternal blood can be used as a new index of predicting fetal distress. The fetal heart monitoring combined determination of HIF-1α could improve the accuracy of assessment of intrauterine fetal anoxia.