BMJ 2001;322:1436-1437 ( 16 June )

Editorials

Electronic fetal monitoring

Is not necessary for low risk labours

Papers p 1457

The first 150 words of the full text of this article appear below.

Electronic fetal monitoring with the cardiotocograph is standard practice during labour in most obstetric units in the United Kingdom. The technique was introduced as a screening test in the 1970s in the belief that it would improve the detection of fetal hypoxaemia and reduce cerebral palsy and perinatal mortality, particularly in high risk pregnancies. Early retrospective observational studies supported the view that it was superior to intermittent auscultation using either a Pinard stethoscope or a hand held doppler ultrasound device.¹ Its use spread rapidly from high risk to low risk pregnancies where the fetus is at least risk from hypoxic events in labour. Was this spread necessary or wise?

By the 1990s systematic reviews of randomised controlled trials of electronic fetal monitoring versus intermittent auscultation during labour had shown no effect on neonatal outcomes such as metabolic acidosis at birth, low Apgar scores or admissions to neonatal intensive care.^2-4 An . . . [Full text of this article]

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This article has been cited by other articles:

• Thomas, J., Paranjothy, S., Kelly, T., Kavanagh, J., Grant, S., Chalmers, I., Smith, G. C S, Stuart, I P, Goddard, R., Mires, G J, Williams, F L R, Howie, P W (2002). Cardiotocography v Doppler auscultation. BMJ 324: 482-482 [Full text]  
• (2001). Is Intensive Fetal Monitoring During Labor Indicated?. JWatch General 2001: 4-4 [Full text]  

Rapid Responses:

Read all Rapid Responses

Routine intrapartum electronic fetal monitoring in low risk women

Gordon C S Smith
bmj.com, 17 Jun 2001 [Full text]

prevent deaths not litigation!

Sara Wright
bmj.com, 19 Jun 2001 [Full text]

A wonderful resource of natural childbirth educators

Susan Myers
bmj.com, 7 Jul 2001 [Full text]