The efficacy of intrapartum electronic fetal monitoring

With basic methodologic criteria as a framework, this report assesses the quality of the seven randomized controlled clinical trials conducted in five countries to compare a policy of routine electronic fetal monitoring with a policy of fetal heart rate monitoring by auscultation. One trial found a statistically significant decrease in the occurrence of neonatal seizures in the electronic fetal monitoring group. The trials demonstrated no other statistically significant benefit associated with the use of electronic fetal monitoring, but most reported significant increases in the rates of abdominal and vaginal operative deliveries associated with electronic fetal monitoring. Taken together, the seven trials provide valuable information about the routine use of intrapartum electronic fetal monitoring; they do not demonstrate that it is a useful screening procedure for all women in labor.