[Fetal monitoring sub partu in West Germany. III. Associations]

If the number of births per year at a clinic is divided by the number of available cardiotocographs, a variable is obtained, designated Q, which reflects the electronic fetal monitoring situation: the larger Q is, the more births per cardiotocograph, and the less satisfactory is the fetal monitoring situation. The smaller Q becomes, the greater the probability that every fetus can be monitored sub partu. Q has an empirical distribution pattern. The median of Q is between 139 and 215 births per year and per monitor, depending on the size of the clinic. There is a significant relationship between the monitoring value Q and the percentage frequency of cesarean and forceps deliveries: the higher the potential monitoring capacity, i.e., the smaller Q is, the higher the number of cesarean and forceps deliveries of a clinic. Intensive monitoring therefore increases the number of surgical deliveries, though no drop in the unadjusted perinatal mortality rate was observed. No association could be established between Q and the risk of fetal acidosis - possibly due to a lack of data. The conclusion drawn from these data is that the theoretical and practical training of obstetricians and midwives in cardiotocography should be further intensified.