The Dublin Randomised Controlled Trial of Intrapartum Electronic Fetal Heart Rate Monitoring

Abstract

The title of my paper concerns the recently completed randomised controlled trial of electronic fetal heart rate monitoring, which was conducted at the National Maternity Hospital, Dublin, over the past 2 years. The trial was conducted because of continuing controversy about the relative merits of continuous electronic fetal monitoring (EFM) versus intermittent auscultation (IA). Although there is some evidence of a consensus that use of the more intensive methods of intrapartum monitoring is appropriate when the fetus is deemed to be at high risk, there is no such agreement concerning the application of these methods for fetuses at average or low risk of adverse outcome. The two expert committees which sat on either side of the Atlantic came to different conclusions concerning the advisability of continuous EFM for all labours:

Periodic auscultation of the fetal heart rate is an acceptable method of assessment of fetal condition for women at low risk of intrapartum fetal distress (National Institutes of Health 1979).

Continuous recording of the fetal heart rate should increasingly become part of the surveillance of all babies during labour (Social Services Committee 1980).