Electronic fetal heart monitoring, auscultation, and neonatal outcome

Article Abstract:

Electronic fetal heart monitoring, a method of monitoring the fetal heart rate, has been used to identify an endangered or deteriorating fetus, particularly during labor and delivery. Although this technique has been valuable in identifying a dying fetus and preventing stillbirth, it has not been as effective in detecting hypoxia-ischemia (a condition of insufficient oxygen supply) of the central nervous system or diminished regulation of the heart rate. Several studies have examined the relation between fetal heart rate and Apgar scores, a system of scoring the infant's physical condition at birth by evaluating the heart rate, breathing effort, muscle tone, responsiveness, and color. There is limited information about the relation between fetal heart monitoring and neurological examination of the newborn. However, most endangered infants improve after birth with the aid of resuscitation and neonatal (newborn) care, and survive until neurological examination can be performed. The relation of maternal and labor-and-delivery factors to newborn outcome was assessed. The fetal heart rate was monitored by either continuous electronic fetal heart rate monitoring or auscultation (using a stethoscope to listen to heart sounds). The results show that only one abnormal pattern, specifically decelerations (decreases in the heart rate) in stage 1 and stage 2 of labor, correlated with neurological examination at birth to 48 hours and 72 hours to one week. The duration of labor after hospital admission, failure of labor to progress, pH values (hydrogen ion levels) in scalp blood specimens, and the presence of meconium (feces) in the amniotic fluid were important in predicting newborn outcome. Abnormal changes in the pattern of the fetal heart rate contributed to variability in the relation between the results of Apgar scoring and neurological examinations. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Diagnosis, Fetus, Auscultation

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Electronic fetal heart rate monitoring: research guidelines for interpretation

Article Abstract:

Participants at the National Institute of Child Health and Human Development workshop on fetal heart rate (FHR) monitoring reviewed clinical research to establish monitoring guidelines and goals for further research. FHR monitoring is used during childbirth to provide early warning when a fetus is at risk of severe asphyxia, which might lead to neurologic damage or death. The workshop participants established standard definitions of fetal heart rate patterns to improve physician understanding, and proposed research to further study the use of FHR monitoring.

Terminology, United States. National Institute of Child Health and Human Development

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Fetal heart rate monitoring: is it salvageable?

Article Abstract:

Researchers discuss the reasons why fetal heart rate monitoring has not improved fetal outcomes. One problem is that there is no standardized interpretation of fetal heart rate patterns.

Evaluation

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