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. 1981 Jun;27:1023–1028.

The Electronic Fetal Monitor: Should Every Mother Have One?

Anthony S Dixon
PMCID: PMC2306034  PMID: 21289757

Abstract

In little more than a decade, the use of electronic fetal monitoring has become standard obstetric practice. Increasingly it is being suggested that all labors should be monitored electronically, and that such universal monitoring will result in improved neonatal outcome. This paper reviews the evidence in what has been termed “the fetal monitoring debate”,1 concluding that there is no indication for monitoring low risk labors, and that in fact too many—rather than too few—labors are being monitored.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Banta H. D., Thacker S. B. Assessing the costs and benefits of electronic fetal monitoring. Obstet Gynecol Surv. 1979 Aug;34(8):627–642. doi: 10.1097/00006254-197908000-00026. [DOI] [PubMed] [Google Scholar]
  2. Beard R. W., Brudenell J. M., Feroze R. M., Clayton S. G. Intensive care of the high risk fetus in labor. J Obstet Gynaecol Br Commonw. 1971 Oct;78(10):882–893. doi: 10.1111/j.1471-0528.1971.tb00199.x. [DOI] [PubMed] [Google Scholar]
  3. Beard R. W., Filshie G. M., Knight C. A., Roberts G. M. The significance of the changes in the continuous fetal heart rate in the first stage of labour. J Obstet Gynaecol Br Commonw. 1971 Oct;78(10):865–881. doi: 10.1111/j.1471-0528.1971.tb00198.x. [DOI] [PubMed] [Google Scholar]
  4. Benson R. C., Shubeck F., Deutschberger J., Weiss W., Berendes H. Fetal heart rate as a predictor of fetal distress. A report from the collaborative project. Obstet Gynecol. 1968 Aug;32(2):259–266. [PubMed] [Google Scholar]
  5. Edington P. T., Sibanda J., Beard R. W. Influence on clinical practice of routine intra-partum fetal monitoring. Br Med J. 1975 Aug 9;3(5979):341–343. doi: 10.1136/bmj.3.5979.341. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Gabert H. A., Stenchever M. A. Continuous electronic monitoring of fetal heart rate during labor. Am J Obstet Gynecol. 1973 Apr 1;115(7):919–923. doi: 10.1016/0002-9378(73)90667-4. [DOI] [PubMed] [Google Scholar]
  7. Goodlin R. C. History of fetal monitoring. Am J Obstet Gynecol. 1979 Feb 1;133(3):323–352. doi: 10.1016/0002-9378(79)90688-4. [DOI] [PubMed] [Google Scholar]
  8. Haverkamp A. D., Orleans M., Langendoerfer S., McFee J., Murphy J., Thompson H. E. A controlled trial of the differential effects of intrapartum fetal monitoring. Am J Obstet Gynecol. 1979 Jun 15;134(4):399–412. doi: 10.1016/s0002-9378(16)33082-4. [DOI] [PubMed] [Google Scholar]
  9. Haverkamp A. D., Thompson H. E., McFee J. G., Cetrulo C. The evaluation of continuous fetal heart rate monitoring in high-risk pregnancy. Am J Obstet Gynecol. 1976 Jun 1;125(3):310–320. doi: 10.1016/0002-9378(76)90565-2. [DOI] [PubMed] [Google Scholar]
  10. Hobbins J. C., Freeman R., Queenan J. T. The fetal monitoring debate. Obstet Gynecol. 1979 Jul;54(1):103–109. doi: 10.1097/00006250-197907000-00023. [DOI] [PubMed] [Google Scholar]
  11. Kelly V. C., Kulkarni D. Experiences with fetal monitoring in a community hospital. Obstet Gynecol. 1973 Jun;41(6):818–824. [PubMed] [Google Scholar]
  12. Kelso I. M., Parsons R. J., Lawrence G. F., Arora S. S., Edmonds D. K., Cooke I. D. An assessment of continuous fetal heart rate monitoring in labor. A randomized trial. Am J Obstet Gynecol. 1978 Jul 1;131(5):526–532. doi: 10.1016/0002-9378(78)90114-x. [DOI] [PubMed] [Google Scholar]
  13. Langendoerfer S., Haverkamp A. D., Murphy J., Nowick K. D., Orleans M., Pacosa F., van Doorninck W. Pediatric follow-up of a randomized controlled trial of intrapartum fetal monitoring techniques. J Pediatr. 1980 Jul;97(1):103–107. doi: 10.1016/s0022-3476(80)80145-4. [DOI] [PubMed] [Google Scholar]
  14. Lee W. K., Baggish M. S. The effect of unselected intrapartum fetal monitoring. Obstet Gynecol. 1976 May;47(5):516–520. [PubMed] [Google Scholar]
  15. Neutra R. R., Fienberg S. E., Greenland S., Friedman E. A. Effect of fetal monitoring on neonatal death rates. N Engl J Med. 1978 Aug 17;299(7):324–326. doi: 10.1056/NEJM197808172990702. [DOI] [PubMed] [Google Scholar]
  16. Paul R. H. Clinical fetal monitoring. Experience on a large clinical service. Am J Obstet Gynecol. 1972 Jul 1;113(5):573–577. doi: 10.1016/0002-9378(72)90623-0. [DOI] [PubMed] [Google Scholar]
  17. Paul R. H., Hon E. H. A clinical fetal monitor. Obstet Gynecol. 1970 Feb;35(2):161–169. [PubMed] [Google Scholar]
  18. Paul R. H., Hon E. H. Clinical fetal monitoring. V. Effect on perinatal outcome. Am J Obstet Gynecol. 1974 Feb 15;118(4):529–533. doi: 10.1016/s0002-9378(16)33695-x. [DOI] [PubMed] [Google Scholar]
  19. Paul R. H., Huey J. R., Jr, Yaeger C. F. Clinical fetal monitoring: its effect on cesarean section rate and perinatal mortality: five-year trends. Postgrad Med. 1977 Apr;61(4):160–166. doi: 10.1080/00325481.1977.11714552. [DOI] [PubMed] [Google Scholar]
  20. Renou P., Chang A., Anderson I., Wood C. Controlled trial of fetal intensive care. Am J Obstet Gynecol. 1976 Oct 15;126(4):470–476. doi: 10.1016/0002-9378(76)90641-4. [DOI] [PubMed] [Google Scholar]
  21. Schifrin B. S., Dame L. Fetal heart rate patterns. Prediction of Apgar score. JAMA. 1972 Mar 6;219(10):1322–1325. [PubMed] [Google Scholar]
  22. Shenker L. Clinical experiences with fetal heart rate monitoring of one thousand patients in labor. Am J Obstet Gynecol. 1973 Apr 15;115(8):1111–1116. doi: 10.1016/0002-9378(73)90561-9. [DOI] [PubMed] [Google Scholar]
  23. Starkman M. N. Fetal monitoring: psychologic consequences and management recommendations. Obstet Gynecol. 1977 Oct;50(4):500–504. [PubMed] [Google Scholar]
  24. WALKER N. The case for conservatism in management of foetal distress. Br Med J. 1959 Dec 5;2(5161):1221–1226. doi: 10.1136/bmj.2.5161.1221. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Youngs D. D., Starkman M. N. Psychological and physiological aspects of electronic fetal monitoring. Prim Care. 1976 Dec;3(4):691–700. [PubMed] [Google Scholar]
  26. Zuspan F. P., Quilligan E. J., Iams J. D., van Geijn H. P. Predictors of intrapartum fetal distress: the role of electronic fetal monitoring. Report of the National Institute of Child Health and Human Development Consensus Development Task Force. Am J Obstet Gynecol. 1979 Oct 1;135(3):287–291. doi: 10.1016/0002-9378(79)90691-4. [DOI] [PubMed] [Google Scholar]

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