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Monitoring the fetus in labor: evidence to support the methods
1University of New Mexico College of Nursing, Albuquerque 87131-5688, USA.
Journal of Midwifery & Women'S Health
|January 11, 2002
Summary
Electronic fetal monitoring (EFM) increases operative deliveries without clear infant benefit. Intermittent auscultation (IA) is a safe alternative for low-risk pregnancies, promoting normal birth.
Area of Science:
- Obstetrics and Gynecology
- Fetal Health Monitoring
Background:
- Electronic fetal monitoring (EFM) became widespread in the US in the 1970s.
- By 1998, EFM use reached 84% of US births, irrespective of caregiver type.
Purpose of the Study:
- To evaluate the efficacy and impact of continuous electronic fetal monitoring (EFM) versus intermittent auscultation (IA) in labor.
- To encourage reconsideration of IA for healthy pregnancies.
Main Methods:
- Review of numerous randomized trials comparing continuous EFM with intermittent auscultation (IA).
Main Results:
- Continuous EFM in labor is associated with an increased rate of operative delivery.
- No clear benefits to the infant have been demonstrated with continuous EFM.
- Intermittent auscultation (IA) is established as safe and effective for low-risk pregnancies.
Conclusions:
- Continuous EFM does not offer clear advantages for fetal well-being and increases operative delivery rates.
- Intermittent auscultation (IA) is a viable, safe option that supports normal birth processes for low-risk pregnancies.
- Clinicians and educators should consider re-evaluating the routine use of EFM in favor of IA for appropriate patient populations.