Do electronic fetal heart rate monitors improve delivery outcomes?

Since the development of electronic fetal heart rate monitors, there has been considerable debate over observable benefits of their use. Early uncontrolled observational studies and retrospective case studies suggested that fetal distress detected by monitoring could help lower both intrapartum and neonatal death rates, serving a utility among high risk deliveries. However, these studies were conducted at a time when neonatal intensive care units and advancing technologies were also beginning to markedly influence perinatal mortality. Randomized clinical trials of the past 10 years have compared electronic monitoring to routine periodic auscultation and have consistently failed to demonstrate a statistically significant difference in either the perinatal mortality rate or the outcome of high risk pregnancies. A few of these studies, however, did report a lower incidence of neurological complications within the monitored deliveries. The latest research, though, has failed to substantiate any long-term neurological benefits from electronic monitoring.