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Related Concept Videos

Fetal Circulation01:14

Fetal Circulation

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Fetal circulation is a unique system that facilitates the exchange of gases, nutrients, and waste products between the developing fetus and the mother. This intricate process takes place through a special organ called the placenta.
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...
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Generational Leaps in Intrapartum Fetal Surveillance.

Lawrence D Devoe1

  • 1Department of Obstetrics and Gynecology, Medical College of Georgia at Augusta University, 1120 15th Street, Augusta, GA 30907, USA.

Diagnostics (Basel, Switzerland)
|October 16, 2025
PubMed
Summary
This summary is machine-generated.

Electronic fetal monitoring (EFM) has not reliably improved perinatal outcomes. Novel systems integrating artificial intelligence and clinical factors, like the Fetal Reserve Index (FRI), show promise for better fetal surveillance.

Keywords:
Fetal Reserve Indexartificial intelligencecomputer-assisted diagnosiselectronic fetal monitoringintelligent systemsintrapartum surveillanceperinatal outcomesrisk assessment

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Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Medicine
  • Medical Technology

Background:

  • Electronic fetal monitoring (EFM) has been a standard for intrapartum fetal surveillance for over 50 years.
  • Despite extensive research, its effectiveness in reducing perinatal morbidity and mortality remains debated.
  • This review explores historical EFM advancements and future surveillance strategies.

Purpose of the Study:

  • To chronologically review the evolution of electronic fetal monitoring (EFM) techniques.
  • To assess the efficacy of ancillary methods and automated systems in improving fetal surveillance.
  • To identify future directions for intelligent intrapartum fetal surveillance systems.

Main Methods:

  • Chronological review of EFM developments, including fetal ECG analysis, automated FHR analysis, and AI.
  • Analysis of the transition from visual interpretation to intelligent systems.
  • Evaluation of automated monitoring platform performance.

Main Results:

  • Ancillary methods and automated systems have shown limited success in improving EFM accuracy.
  • Fetal ECG analysis has shown some benefit when combined with visual interpretation.
  • Novel approaches like the Fetal Reserve Index (FRI) demonstrate potential by integrating clinical risk factors.

Conclusions:

  • Visual interpretation of fetal heart rate (FHR) patterns has persistent limitations.
  • Future systems require comprehensive risk assessment combining maternal, fetal, and obstetric factors.
  • Integrating AI with contextualized metrics like FRI offers the most promising path for improved outcomes.