Fetal monitoring during labour

Abstract

The process of labour and delivery can be a hazardous journey for the fetus. The principal aim of monitoring a fetus during labour is to detect changes in the fetal heart rate that suggest a possibility of fetal hypoxia and metabolic acidosis so that timely action can be taken to prevent adverse outcomes. For the last four decades, intrapartum monitoring of fetuses has been commonly performed by either intermittent auscultation or electronic fetal heart rate monitoring (EFM). While intermittent auscultation has been the method of choice in low-risk pregnancies and in settings with limited resources, continuous EFM by cardiotocography has formed the mainstay of fetal surveillance in high-risk pregnancies in most of the high-resourced countries. The terminology, classification, and threshold for intervention with the use of EFM are discussed and adjunct technologies that support the use of EFM are also considered.