Intrapartum fetal heart rate monitoring: nomenclature, interpretation, and general management principles

George A. Macones

Research output: Contribution to journalReview article

436 Scopus citations

Abstract

In the most recent year for which data are available, approximately 3.4 million fetuses (85% of approximately 4 million live births) in the United States were assessed with electronic fetal monitoring (EFM), making it the most common obstetric procedure (1). Despite its widespread use, there is controversy about the efficacy of EFM, interobserver and intraobserver variability, nomenclature, systems for interpretation, and management algorithms. Moreover, there is evidence that the use of EFM increases the rate of cesarean deliveries and operative vaginal deliveries. The purpose of this document is to review nomenclature for fetal heart rate assessment, review the data on the efficacy of EFM, delineate the strengths and shortcomings of EFM, and describe a system for EFM classification.

Original languageEnglish
Pages (from-to)192-202
Number of pages11
JournalObstetrics and gynecology
Volume114
Issue number1
DOIs
StatePublished - Jul 1 2009

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