[Cardiotocographic recording during labor: problems and alternatives]

Over the past few years there has been a notable decrease in fetal morbid mortality due to intrauterine asphyxia. Currently there is a controversy about the role which electronic monitoring of uterine contractions and of fetal cardiac frequency during birth has played in the aforementioned decrease. The frequent nonspecificness and/or the subjectivity in interpreting these recordings, coupled with the risk of reducing the direct contact with the mother, are a few of the limitations which can reduce the efficiency of electronic monitoring. Various complementary fetal control methods, some of which in current clinical usage such as fetal scalp pH, fetal EKG, fetal pulsimeter readings, doppler flux metering, or vibra-acoustic stimulation and others which are undergoing testing such as infrared spectroscope can increase the predictive efficiency of electronic monitoring. Some of the ideas included in this article were presented in the VII Course for "New Perspectives in Obstetrics and Gynecology" held in Salamanca.