Journal ArticleDOI
Effects of electronic fetal-heart-rate monitoring, as compared with periodic auscultation, on the neurologic development of premature infants.
Kirkwood K. Shy,David A. Luthy,Forrest C. Bennett,Michael F. Whitfield,Eric B. Larson,G. van Belle,James P. Hughes,Judy Wilson,Morton A. Stenchever +8 more
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It is concluded that as compared with a structured program of periodic auscultation, electronic fetal monitoring does not result in improved neurologic development in children born prematurely.Abstract:
In a multicenter, randomized clinical trial, we assessed the early neurologic development of 93 children born prematurely whose heart rates were monitored electronically during delivery and compared it with that of 96 children born prematurely whose heart rates were periodically monitored by auscultation. All the children were singletons with cephalic presentation, and all weighed less than or equal to 1750 g at birth. The mental and psychomotor indexes of the Bayley Scales of Infant Development (standardized mean score +/- SD, 100 +/- 16) and a formal neurologic examination were administered at three follow-up visits (at 4, 8, and 18 months of age, corrected for gestational age). At 18 months, the mean mental-development scores in the groups receiving electronic fetal monitoring and periodic auscultation were 100.5 +/- 2.4 and 104.9 +/- 1.8, respectively (P greater than 0.1). The mean psychomotor-development scores in the two groups at 18 months were 94.0 +/- 2.4 and 98.3 +/- 1.8, respectively (P greater than 0.1). The incidence of cerebral palsy was higher in the electronically monitored group--20 percent as compared with 8 percent in the group that was monitored by auscultation (P less than 0.03). In the electronic-fetal-monitoring group (but not in the periodic-auscultation group), the risk of cerebral palsy increased with the duration of abnormal fetal-heart-rate patterns, as assessed by retrospective review (chi 2 trend = 12.71, P less than 0.001). The median time to delivery after the diagnosis of abnormal fetal-heart-rate patterns was 104 minutes with electronic fetal monitoring, as compared with 60 minutes with periodic auscultation. We conclude that as compared with a structured program of periodic auscultation, electronic fetal monitoring does not result in improved neurologic development in children born prematurely.read more
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Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour
TL;DR: Evaluated the effectiveness and safety of continuous cardiotocography when used as a method to monitor fetal wellbeing during labour, which showed no significant improvement in overall perinatal death rate.
Journal ArticleDOI
How much of neonatal encephalopathy is due to birth asphyxia
Karin B. Nelson,Alan Leviton +1 more
TL;DR: It is concluded that the proportion of neonatal encephalopathy that is asphyxial in origin is not known but warrants examination, especially in view of the probable need in the near future to identify suitable candidates for clinical trials of powerful but risky treatments of birth asphyxia.
Journal ArticleDOI
Temporal and demographic trends in cerebral palsy—Fact and fiction
TL;DR: The rate of cerebral palsy has not decreased in developed countries over the past 30 years despite the widespread use of electronic fetal heart rate monitoring and a 5-fold increase in the cesarean delivery rate over the same period of time.
Reference EntryDOI
Continuous electronic heart rate monitoring for fetal assessment during labor.
TL;DR: The only clinically significant benefit from the use of routine continuous EFM was in the reduction of neonatal seizures, and the long-term benefit of this reduction must be evaluated in the decision reached jointly by the pregnant woman and her clinician to use continuous E FM or intermittent auscultation during labor.
Journal ArticleDOI
Fetal health surveillance: antepartum and intrapartum consensus guideline.
Robert M. Liston,Diane Sawchuck,David Young,Normand Brassard,Kim Campbell,Greg Davies,William Ehman,Dan Farine,Duncan F. Farquharson,Emily F. Hamilton,Michael Helewa,Owen Hughes,Ian Lange,Jocelyne Martel,Vyta Senikas,Ann E. Sprague,Bernd K. Wittmann,Martin Pothier,Judy Scrivener +18 more
TL;DR: This guideline provides new recommendations pertaining to the application and documentation of fetal surveillance in the antepartum and intrapartum period that will decrease the incidence of birth asphyxia while maintaining the lowest possible rate of obstetrical intervention.
References
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