Electronic Fetal Monitoring: Past, Present, and Future

Clinics in Perinatology

Volumn 38, Issue 1, 2011, Pages 127-142

  Stout, Molly J ^a   Cahill, Alison G ^b  

^a WASHINGTON UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b WASHINGTON UNIVERSITY   (United States)

Author keywords

Electronic fetal monitoring; Intrapartum continuous monitoring; Neonatal outcomes

Indexed keywords

AUSCULTATION; CARDIOTOCOGRAPHY; CEREBRAL PALSY; CLINICAL DECISION MAKING; CLINICAL PRACTICE; DELIVERY; DISEASE ASSOCIATION; EARLY DIAGNOSIS; ELECTROCARDIOGRAPHY; FETAL WELL BEING; FETUS HEART RATE; FETUS HYPOXIA; FETUS MONITORING; FETUS OUTCOME; HEART RATE VARIABILITY; HIGH RISK PREGNANCY; HUMAN; LABOR; METABOLIC ACIDOSIS; NONHUMAN; OUTCOME ASSESSMENT; PRIORITY JOURNAL; REVIEW; UTERUS CONTRACTION;

AUSCULTATION; BIRTH INJURIES; CARDIOTOCOGRAPHY; DELIVERY, OBSTETRIC; FEMALE; FETAL DISTRESS; FORECASTING; HEART RATE, FETAL; HISTORY, 20TH CENTURY; HISTORY, 21ST CENTURY; HUMANS; LABOR, OBSTETRIC; PREGNANCY; PREGNANCY COMPLICATIONS;

EID: 79951830078     PISSN: 00955108     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.clp.2010.12.002     Document Type: Review

References (40)

1. Martin J.A., Hamilton B.E., Sutton P.D., et al. Births: final data for 2002. Natl Vital Stat Rep 2003, 52(10):1-113.
2. Creasy R.K., Resnik R., Iams J.D., et al. Maternal-fetal medicine principles and practice 2009, Saunders Elsevier, Philadelphia. 6th edition.
3. Kubli F.W., Hon E.H., Khazin A.F., et al. Observations on heart rate and pH in the human fetus during labor. Am J Obstet Gynecol 1969, 104(8):1190-1206.
4. Myers R.E., Mueller-Heubach E., Adamsons K. Predictability of the state of fetal oxygenation from a quantitative analysis of the components of late deceleration. Am J Obstet Gynecol 1973, 115(8):1083-1094.
5. Murata Y., Martin C.B., Ikenoue T., et al. Fetal heart rate accelerations and late decelerations during the course of intrauterine death in chronically catheterized rhesus monkeys. Am J Obstet Gynecol 1982, 144(2):218-223.
6. Quilligan E.J., Paul R.H. Fetal monitoring: is it worth it?. Obstet Gynecol 1975, 45(1):96-100.
7. Renou P., Chang A., Anderson I., et al. Controlled trial of fetal intensive care. Am J Obstet Gynecol 1976, 126(4):470-476.
8. Haverkamp A.D., Thompson H.E., McFee J.G., et al. The evaluation of continuous fetal heart rate monitoring in high-risk pregnancy. Am J Obstet Gynecol 1976, 125(3):310-320.
9. Kelso I.M., Parsons R.J., Lawrence G.F., et al. An assessment of continuous fetal heart rate monitoring in labor. A randomized trial. Am J Obstet Gynecol 1978, 131(5):526-532.
10. Haverkamp A.D., Orleans M., Langendoerfer S., et al. A controlled trial of the differential effects of intrapartum fetal monitoring. Am J Obstet Gynecol 1979, 134(4):399-412.
11. MacDonald D., Grant A., Sheridan-Pereira M., et al. The Dublin randomized controlled trial of intrapartum fetal heart rate monitoring. Am J Obstet Gynecol 1985, 152(5):524-539.
12. Vintzileos A.M., Antsaklis A., Varvarigos I., et al. A randomized trial of intrapartum electronic fetal heart rate monitoring versus intermittent auscultation. Obstet Gynecol 1993, 81(6):899-907.
13. Leveno K.J., Cunningham F.G., Nelson S., et al. A prospective comparison of selective and universal electronic fetal monitoring in 34,995 pregnancies. N Engl J Med 1986, 315(10):615-619.
14. Luthy D.A., Shy K.K., van Belle G., et al. A randomized trial of electronic fetal monitoring in preterm labor. Obstet Gynecol 1987, 69(5):687-695.
15. Shy K.K., Luthy D.A., Bennett F.C., et al. Effects of electronic fetal-heart-rate monitoring, as compared with periodic auscultation, on the neurologic development of premature infants. N Engl J Med 1990, 322(9):588-593.
16. Electronic fetal heart rate monitoring: research guidelines for interpretation. National Institute of Child Health and Human Development research planning workshop. Am J Obstet Gynecol 1997, 177(6):1385-1390.
17. Screening for intrapartum electronic fetal monitoring Available at:, Accessed January 19, 2011. http://www.uspreventiveservicestaskforce.org/uspstf/uspsiefm.htm.
18. Advance report of maternal and infant health data from the birth certificate, 1990. Mon Vital Stat Rep 1993, 42(Suppl 2). Available at:, Accessed December 24, 2010. http://www.cdc.gov/nchs/products/mvsr/mvsr43_5s.htm.
19. Samueloff A., Langer O., Berkus M., et al. Is fetal heart rate variability a good predictor of fetal outcome?. Acta Obstet Gynecol Scand 1994, 73(1):39-44.
20. Spencer J.A., Badawi N., Burton P., et al. The intrapartum CTG prior to neonatal encephalopathy at term: a case-control study. Br J Obstet Gynaecol 1997, 104(1):25-28.
21. Low J.A., Victory R., Derrick E.J. Predictive value of electronic fetal monitoring for intrapartum fetal asphyxia with metabolic acidosis. Obstet Gynecol 1999, 93(2):285-291.
22. Sameshima H., Ikenoue T. Predictive value of late decelerations for fetal acidemia in unselective low-risk pregnancies. Am J Perinatol 2005, 22(1):19-23.
23. Williams K.P., Galerneau F. Fetal heart rate parameters predictive of neonatal outcome in the presence of a prolonged deceleration. Obstet Gynecol 2002, 100(5 Pt 1):951-954.
24. Clark S.L., Hankins G.D. Temporal and demographic trends in cerebral palsy-fact and fiction. Am J Obstet Gynecol 2003, 188(3):628-633.
25. Hankins G.D., Speer M. Defining the pathogenesis and pathophysiology of neonatal encephalopathy and cerebral palsy. Obstet Gynecol 2003, 102(3):628-636.
26. Larma J.D., Silva A.M., Holcroft C.J., et al. Intrapartum electronic fetal heart rate monitoring and the identification of metabolic acidosis and hypoxic-ischemic encephalopathy. Am J Obstet Gynecol 2007, 197(3):301. e1-8.
27. Nelson K.B., Dambrosia J.M., Ting T.Y., et al. Uncertain value of electronic fetal monitoring in predicting cerebral palsy. N Engl J Med 1996, 334(10):613-618.
28. Badawi N., Kurinczuk J.J., Keogh J.M., et al. Antepartum risk factors for newborn encephalopathy: the Western Australian case-control study. BMJ 1998, 317(7172):1549-1553.
29. Badawi N., Kurinczuk J.J., Keogh J.M., et al. Intrapartum risk factors for newborn encephalopathy: the Western Australian case-control study. BMJ 1998, 317(7172):1554-1558.
30. Sameshima H., Ikenoue T., Ikeda T., et al. Association of nonreassuring fetal heart rate patterns and subsequent cerebral palsy in pregnancies with intrauterine bacterial infection. Am J Perinatol 2005, 22(4):181-187.
31. American College of Obstetricians and Gynecologists' Task Force on Neonatal Encephalopathy, Cerebral Palsy and the American College of Obstetricians and Gynecologists, American Academy of Pediatrics Neonatal encephalopathy and cerebral palsy: defining pathogenesis and pathophysiology 2003, American College of Obstetricians and Gynecologists, Washington, DC.
32. American College of Obstetricians and Gynecologists ACOG practice bulletin. Clinical management guidelines for obstetrician-gynecologists, number 70, December 2005 (replaces practice bulletin number 62, May 2005). Intrapartum fetal heart rate monitoring. Obstet Gynecol 2005, 106(6):1453-1460.
33. American College of Obstetricians and Gynecologists ACOG practice bulletin No. 106: intrapartum fetal heart rate monitoring: nomenclature, interpretation, and general management principles. Obstet Gynecol 2009, 114(1):192-202.
34. Zarko A., Declan D., Gillian M.L. Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour. Cochrane Database Syst Rev 2008, 2.
35. Macones G.A., Hankins G.D., Spong C.Y., et al. The 2008 National Institute of Child Health and Human Development workshop report on electronic fetal monitoring: update on definitions, interpretation, and research guidelines. Obstet Gynecol 2008, 112(3):661-666.
36. Parer J.T., Ikeda T., King T.L. The 2008 National Institute of Child Health and Human Development report on fetal heart rate monitoring. Obstet Gynecol 2009, 114(1):136-138.
37. Elliott C., Warrick P.A., Graham E., et al. Graded classification of fetal heart rate tracings: association with neonatal metabolic acidosis and neurologic morbidity. Am J Obstet Gynecol 2010, 202(3):258. e1-8.
38. Melin M., Bonnevier A., Cardell M., et al. Changes in the ST-interval segment of the fetal electrocardiogram in relation to acid-base status at birth. BJOG 2008, 115(13):1669-1675.
39. Freeman J.M. Beware: the misuse of technology and the law of unintended consequences. Neurotherapeutics 2007, 4(3):549-554.
40. Wood C., Renou P., Oats J., et al. A controlled trial of fetal heart rate monitoring in a low-risk obstetric population. Am J Obstet Gynecol 1981, 141(5):527-534.