Fetal monitoring and assessment

The standard of care for intrapartum fetal assessment prior to the introduction of electronic fetal monitoring (EFM) in the mid-20th century was intermittent auscultation of fetal heart tones and fetal scalp pH sampling. Heart rate decelerations are decreases in the fetal heart rate below the baseline, and are classified as variable, early, late, or prolonged. The term 'tachysystole' is to replace any historically used terms to refer to high-frequency contraction patterns, such as hyperstimulation or hypercontractility. Tachysystole may be accompanied by fetal heart rate decelerations, or may not be, and it is presence of the former that typically requires clinical intervention. New understanding of labor, but mechanistically and at the bedside, as well as robust study design and novel analytic techniques are just some of the tools that scientists are currently harnessing to enable providers to improve obstetric care at the bedside with regard to intrapartum fetal assessment and interpretation.