Fetal heart rate monitoring in labour: A critical review
Continuous monitoring of the fetal heart rate (FHR) during labour has become widespread since its introduction into clinical practice during the 1960s. However, there has been increasing criticism of its routine use in recent years because of growing doubts about its effectiveness. Although early reports suggested that continuous FHR monitoring in high risk labour was associated with a reduction in the incidence of fetal and neonatal deaths related to labour (23, 36) there has been no evidence to show a similar benefit in terms of perinatal morbidity or long-term neurodevelopmental handicap. If anything, routine use of continuous FHR monitoring has been associated with an increase in operative delivery rates and an increasing rate of medico-legal cases against hospitals. Clearly, early expectations of the value of continuous FHR monitoring have not been realised.
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- 4.Cibils LA (1978) Clinical significance of fetal heart rate patterns during labour V. Variable decelerations. Am J Obstet Gynaecol 132: 791–803Google Scholar
- 19.Hon EH (1968) An atlas of fetal heart rate patterns. Harty Press, New Haven.Google Scholar
- 20.Ingemarsson E (1981) Routine electronic fetal monitoring during labour. Acta Obstet Gynecol Scand, suppl 99Google Scholar
- 23.Johnstone FD, Campbell DM, Hughes GJ (1978) Has continuous intrapartum monitoring made any impact on fetal outcome? Lancet I:1290–1300Google Scholar
- 39.Spencer JAD (1989) Fetal heart rate variability. In Progress in Obstetrics and Gynaecology, volume 7 (Studd J ed), Churchill Livingstone, Edinburgh, pp 103–122Google Scholar
- 42.Spencer JAD, Ward HRT (1993) Intrapartum Fetal Surveillance. Royal College of Obstetricians and Gynaecologists Press, LondonGoogle Scholar
- 46.Tejani N, Mann LI, Bhakthavathsalan A, Weiss RR (1975) Correlation of fetal heart rate — uterine contraction patterns with fetal scalp blood pH. Obstet Gyncol 46, 392–396Google Scholar
- 48.Thacker SB (1991) Effectiveness and safety of intrapartum fetal monitoring. In Fetal Monitoring (Spencer JAD ed), Oxford University Press, Oxford, pp 211–217.Google Scholar