Future perspectives in intrapartum fetal surveillance

Area of Science:

• Obstetrics and Gynecology
• Perinatal Medicine
• Fetal Monitoring

Background:

• Electronic fetal monitoring (EFM) has been used for over 40 years for intrapartum fetal surveillance.
• Despite numerous trials, its effectiveness in reducing perinatal morbidity and mortality remains uncertain.
• Ancillary methods and automated systems have been developed to improve EFM accuracy, but widespread adoption and proven benefits are limited.

Purpose of the Study:

• To review the current state of electronic fetal monitoring (EFM).
• To discuss limitations of current FHR pattern interpretation.
• To explore future directions for novel intrapartum fetal surveillance systems.

Main Methods:

• Review of existing literature on electronic fetal monitoring (EFM) and fetal heart rate (FHR) analysis.
• Discussion of ancillary methods, including fetal electrocardiogram (ECG) analysis.
• Exploration of automated FHR analysis systems and their potential.

Main Results:

• The impact of EFM on perinatal outcomes, particularly morbidity and mortality, is still unclear.
• Limited studies suggest fetal ECG analysis may improve outcomes, but visual interpretation challenges persist.
• Automated FHR analysis systems are not yet widely used or proven to enhance surveillance.

Conclusions:

• Novel intrapartum fetal surveillance systems are needed to improve risk assessment and prognosis.
• Future systems should leverage EFM experience to enhance accuracy and clinical value.
• Further research and development are required for advanced fetal surveillance technologies.