Maternal or fetal heart rate? Avoiding intrapartum misidentification

Electronic fetal monitoring technology is capable of monitoring and recording maternal heart rate (MHR) patterns that mimic fetal heart rate (FHR) patterns. The ability to distinguish one from the other requires knowledge of FHR and MHR characteristics and monitoring technology. Application of this knowledge may prevent fetal injury and death. This article reviews heart rate monitoring technology and the similarities and differences between MHR and FHR baselines, accelerations, and decelerations. Three case reports are described in which the MHR was mistaken for the FHR prior to the diagnosis of fetal demise. Guidelines to confirm fetal life and prevent misidentification are proposed.