Abstract
The goal of peripartum fetal monitoring is improved neonatal outcomes, primarily neurological. Fetal monitoring may allow both obstetricians and anesthesiologists to provide more timely and specific intervention to the parturient and fetus, while ideally minimizing risks. Fetal monitoring technology has improved over the past 50 years, but classification and interpretation have lagged. It is hoped that increased attention to standardization of definitions, interpretation, and interventions, along with new emerging technology, will enhance electronic fetal monitoring’s effectiveness in assessment of fetal well-being and its contribution to better neonatal outcomes.
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Quilligan EJ, Paul RH. Fetal monitoring: is it worth it? Obstet Gynecol. 1975;45:96–100.
Clark SL, Hankins GVD. Temporal and demographic trends in cerebral palsy: fact and fiction. Am J Obstet Gynecol. 2003;188:628–33.
Graham EM, Ruis KA, Hartman AL, Nothington FJ, Fox HE. A systemic review of the role of intrapartum hypoxia-ischemia in the causation of neonatal encephalopathy. Am J Obstet Gynecol. 2008;199:587–95.
Chen HY, Chauhan SP, Ananth CV, Vintzileos AM, Abuhamad AZ. Electronic fetal heart rate monitoring and its relationship to neonatal and infant mortality in the United States. Am J Obstet Gynecol. 2011;204:491.e1–10.
Alfirevic Z, Devane D, Gyte GM. Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour. Cochrane Database Syst Rev. 2006;(3):CD006066.
Phelen JP, Korst LM, Martin GI. Application of criteria developed by the task force on neonatal encephalopathy and cerebral palsy to acutely asphyxiated neonates. Obstet Gynecol. 2011;118:824–30.
Thorgren-Jerneck K, Herbst A. Perinatal factors associated with cerebral palsy in children born in Sweden. Obstet Gynecol. 2006;108:1499–505.
Sureau C. Historical perspectives: forgotten past, unpredictable future. Baillieres Clin Obstet Gynaecol. 1996;10:167–84.
Hon EH. Apparatus for continuous monitoring of the fetal heart rate. Yale J Biol Med. 1960;32:397–9.
Grimes DA, Schulz KF. Uses and abuses of screening tests. Lancet. 2002;359:881–4.
Grimes DA, Peipert JF. Electronic fetal monitoring as a public health screening program: the arithmetic of failure. Obstet Gynecol. 2010;116:1397–400.
Bernardes J, Ayres-de-Campos D. The persistent challenge of foetal heart rate monitoring. Curr Opin Obstet Gynecol. 2010;22:104–9.
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;114:192–202.
Costantine MM, Saade GR. The first cesarean: role of “fetal distress” diagnosis. Semin Perinatol. 2012;36:379–83.
The National Institute of Child Health and Human Development Research Planning Workshop. Electronic fetal heart rate monitoring: research guidelines for interpretation. J Obstet Gynecol Neonatal Nurs. 1997;26:635–40.
Macones GA, Hankins GDV, Spong CY, Hauth J, Moore T. The 2008 National Institute of Child Hand Human Development workshop report on fetal monitoring: update on definitions, interpretations, and research guidelines. Obstet Gynecol. 2008;112:661–6.
American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 116: management of intrapartum fetal heart rate tracings. Obstet Gynecol. 2010;116:1232–40.
Miller DA, Miller LA. Electronic fetal heart rate monitoring: applying principles of patient safety. Am J Obstet Gynecol. 2012;206:278–83.
Garite TJ, Simpson KR. Intrauterine resuscitation during labor. Clin Obstet Gynecol. 2011;54:28–39.
Parer JT, Ikeda T. A framework for standardized management of intrapartum fetal heart rate patterns. Am J Obstet Gynecol. 2007;197:26.e1–6.
Parer JT, Hamilton EF. Comparison of 5 experts and computer analysis in rule-based fetal heart rate interpretation. Am J Obstet Gynecol. 2010;203:451.e1–7.
Coletta J, Murphy E, Rubeo Z, Gyamfi-Bannerman C. The 5-tier system of assessing fetal heart rate tracings is superior to the 3-tier system in identifying fetal acidemia. Am J Obstet Gynecol. 2012;206:226.e1–5.
Sadaka A, Furuhashi M, Minami H, Miyazaki K, Yoshida K, Ishikawa K. Observation on validity of the five-tier system for fetal heart rate pattern interpretation proposed by Japan Society of Obstetricians and Gynecologists. J Matern Fetal Neonatal Med. 2011;24:1465–9.
Goodwin TM, Milner-Masterson L, Paul RH. Elimination of fetal scalp blood sampling on a large clinical service. Obstet Gynecol. 1994;83:971–4.
East CE, Leader LR, Sheehan P, Henshall NE, Colditz PB. Intrapartum fetal scalp lactate sampling for fetal assessment in the presence of a non-reassuring fetal heart rate trace. Cochrane Database Syst Rev. 2010;(3):CD006174.
American College of Obstetricians and Gynecologists Committee on Obstetric Practice. ACOG Committee opinion number 258, September 2001: fetal pulse oximetry. Obstet Gynecol. 2001;98:523–4.
Stiller R, von Mering R, König V, Huch A, Huch R. How well does reflectance pulse oximetry reflect intrapartum fetal acidosis? Am J Obstet Gynecol. 2002;186:1351–7.
Wiberg-Itzel E, Lipponer C, Norman M, Herbst A, Prebensen D, Hansson A, et al. Determination of pH or lactate in fetal scalp blood in management of intrapartum fetal distress: randomised controlled multicentre trial. BMJ. 2008;336:1284–7.
Bloom SL, Spong CY, Thom E, Varner MW, Rouse DJ, Weininger S, et al. Fetal pulse oximetry and cesarean delivery. N Engl J Med. 2006;355:2195–202.
Lilja H, Greene KR, Karlsson K, Rosen KG. ST waveform changes of the fetal electrocardiogram during labor: a clinical study. Br J Obstet Gynaecol. 1985;92:611–7.
Westgate J, Harris M, Curnow JS, Greene KR. Plymouth randomized trial of cardiotocogram only versus ST waveform plus cardiotocogram for intrapartum monitoring in 2400 cases. Am J Obstet Gynecol. 1993;169:1151–60.
Amer-Wahlin I, Hellsten C, Noren H, Hagberg H, Herbst A, Kjellmer I, et al. Cardiotocography only versus cardiotocography plus ST analysis of fetal electrocardiogram for intrapartum fetal monitoring: a Swedish randomised controlled trial. Lancet. 2001;358:534–8.
Noren H, Amer-Wahlin I, Hagberg H, Herbst A, Kjellmer I, Marsal K, et al. Fetal electrocardiography in labor and neonatal outcome: data from the Swedish randomized controlled trial on intrapartum fetal monitoring. Am J Obstet Gynecol. 2003;188:183–92.
Westerhuis ME, Visser GH, Moons KG, van Beek E, Benders MJ, Bijvoet SM, et al. Cardiotocography plus ST analysis of fetal electrocardiogram compared with cardiotocography only for intrapartum monitoring: a randomized controlled trial. Obstet Gynecol. 2010;115:1173–80.
Noren H, Carlsson A. Reduced prevalence of metabolic acidosis at birth: an analysis of established STAN usage in the total population of deliveries in a Swedish district hospital. Am J Obstet Gynecol. 2010;202:546.e1–7.
Potti S, Berghella V. ST waveform analysis versus cardiotocography along for intrapartum fetal monitoring: a meta-analysis of randomized trials. Am J Perinatol. 2012;29:657–64.
Yli BM, Kessler J, Eikeland T, Hustad BL, Dragnes W, Henriksen T. What is the gold standard for intrapartum fetal monitoring? Acta Obstet Gynecol Scand. 2012;91:1011–4.
American College of Nurse Midwives. Intermittent auscultation for intrapartum fetal heart rate surveillance. J Midwifery Womens Health. 2010;55:397–403.
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Buck, M.V., Richardson, M.G. (2014). Fetal Monitoring. In: Ehrenfeld, J., Cannesson, M. (eds) Monitoring Technologies in Acute Care Environments. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8557-5_42
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