Why has conventional intrapartum cardiotocography not given the expected results?

It is probable that conventional electronic fetal monitoring (EFM) has reduced the intrapartum death rate, but the expected dramatic reduction in neurological handicap has not occurred. There are two reasons for this: the majority of infants, who develop neurological problems have been harmed before the onset of labor, and the method of EFM has been more difficult to use in daily routine than expected. However, EFM is the best method we have to monitor high risk cases and the results can be improved by better training of the staff.