Electronic Fetal Monitoring and Cesarean Birth: A Scoping Review

Birth ◽  
2016 ◽  
Vol 43 (4) ◽  
pp. 277-284 ◽  
Author(s):  
Mary T. Paterno ◽  
Kathleen McElroy ◽  
Mary Regan
Keyword(s):  
Scoping Review ◽  
Fetal Monitoring ◽  
Cesarean Birth ◽  
Electronic Fetal Monitoring

What Do Women Want? Consent for the Use of Electronic Fetal Monitoring

2021 ◽  
Vol 11 (3) ◽  
pp. 145-153
Author(s):  
Sonya Dal Cin ◽  
Lisa Kane Low ◽  
Denise Lillvis ◽  
Megan Masten ◽  
Raymond De Vries
Keyword(s):  
United States ◽  
Healthcare Providers ◽  
Fetal Monitoring ◽  
Healthcare Setting ◽  
Professional Associations ◽  
The United States ◽  
Cesarean Birth ◽  
Electronic Fetal Monitoring ◽  
Risk Patients

BACKGROUNDGuidelines published by professional associations of midwives, obstetricians, and nurses in the United States recommend against using continuous cardiotocography (CTG) in low-risk patients. In the United States, CTG or electronic fetal/uterine monitoring (EFM) rather than auscultation with a fetoscope or Pinard horn is the norm. Interpretation of the fetal heart rate (FHR) and uterine activity (UA) tracings provided by continuous EFM may be associated with the decision for a cesarean birth. Typically, consent is not sought in the decision about type of monitoring. No studies were identified where women's attitudes about the need to consent to the type of fetal monitoring used during labor have been explored. Therefore, the purpose of this research was to examine women's attitudes about the use of EFM in a healthcare setting.METHODSWe asked a sample of women aged 18–50 years to respond to one of three monitoringscenarios. The scenarios were used to distinguish between attitudes about monitoring in general, monitoring the health of a mother in labor, and monitoring the health of the fetus during labor. Wemeasured their level of interest in being monitored and their opinions about whether healthcare providers should be required to obtain consent for the monitoring described in the scenario.RESULTSInterest in receiving monitoring (across all three scenarios) was moderate, with the highest level of interest in monitoring the fetus during labor and the least interest in monitoring a general health context. Across all scenarios, 82% of respondents believed that practitioners should obtain consent for monitoring, 14% were unsure, and 4% said there should not be a requirement for consent. While low (6%), the percentage responding that consent was not needed was highest in monitoring a fetus in labor.CONCLUSIONSWomen in our study expressed a strong preference for the opportunity to consent to the use of monitoring regardless of the healthcare scenario. There is findings suggest the need for further research exploring what women do and do not know about CTG and what their informed performance are a pressing need to rethink the role of a pressing need to rethink the role of shared decision-making and informed consent about the type of monitoring use during labor.

Hooked Up

2012 ◽  
Vol 16 (1) ◽  
pp. 45-61
Author(s):  
Tanya N. Cook ◽  
Keyword(s):  
Fetal Monitoring ◽  
Low Risk ◽  
Embodied Experience ◽  
Cesarean Birth ◽  
Patient Interactions ◽  
Norms And Values ◽  
Electronic Fetal Monitoring ◽  
The Status ◽  
Maternal Autonomy ◽  
Low Risk Women

Near ubiquitous use of electronic fetal monitoring (EFM) during low-risk childbirth constrains both maternal agency and maternal autonomy. An analysis of interdisciplinary literature about EFM reveals that its use cannot be understood apart from broader norms and values that have significant implications for the agency and autonomy of laboring women. Overreliance on EFM use for low-risk women threatens their autonomy in several ways: by privileging the status of the fetal patient, by delegitimizing women’s embodied experience of childbirth, and by constructing EFM data as objective science despite evidence to the contrary. In birth situations defined as high-risk, however, EFM may lead to greater maternal agency by enabling women to choose vaginal over cesarean birth. Viewing doctor-patient interactions as a co-construction in the context of an understanding that sees EFM as a social as well as technological construction may improve autonomy in childbirth.

Electronic Fetal Monitoring and Cesarean Birth

2017 ◽  
Vol 37 (4) ◽  
pp. 194-195
Author(s):  
M.T. Paterno ◽  
K. McElroy ◽  
M. Regan
Keyword(s):  
Fetal Monitoring ◽  
Cesarean Birth ◽  
Electronic Fetal Monitoring

738 Sex-specific differences in electronic fetal monitoring patterns

2021 ◽  
Vol 224 (2) ◽  
pp. S462-S463
Author(s):  
Erin Bailey ◽  
Nandini Raghuraman ◽  
Fan Zhang ◽  
Jeny Ghartey ◽  
George A. Macones ◽  
...  
Keyword(s):  
Fetal Monitoring ◽  
Electronic Fetal Monitoring

Electronic fetal monitoring in the twenty-first century: Language, logic and Lewis Carroll

2020 ◽  
pp. 147775092097180
Author(s):  
Thomas P Sartwelle ◽  
James C Johnston ◽  
Berna Arda ◽  
Mehila Zebenigus
Keyword(s):  
Medical Literature ◽  
Medical Profession ◽  
Scientific Research ◽  
Fetal Monitoring ◽  
First Century ◽  
Lewis Carroll ◽  
Evidence Based ◽  
Electronic Fetal Monitoring ◽  
Complete Failure ◽  
Twenty First Century

The Alice Books, full of illogical thoughts, words, and contradictions, were unrivaled entertainment until the publication of the medical literature promoting electronic fetal monitoring (EFM) for every pregnancy. The modern-day EFM advocates acknowledge EFM’s decades long failure but simultaneously recommend EFM use for lawsuit protection and because the profession has used EFM for every pregnancy for fifty years, therefore, it must be efficacious. These self-indulgent, illogical rationalizations ignore the half century of evidence-based scientific research proving that EFM is a complete failure as well as ignoring the fact that continued EFM use violates the fundamental principles of modern bioethics. This blind advocacy perpetuates four pernicious EFM harms occurring to mothers, babies, and the medical profession itself. This article sets out these four EFM harms with the goal of abolishing the misguided, illogical, contradictory, arguments used by the twenty-first century EFM Lewis Carroll mimics.

Electronic Fetal Monitoring: Physician Liability and Informed Consent

1984 ◽  
Vol 10 (1) ◽  
pp. 31-91
Author(s):  
Myra Gerson Gilfix
Keyword(s):  
Informed Consent ◽  
Fetal Monitoring ◽  
Standard Of Care ◽  
Legal Issues ◽  
Standards Of Care ◽  
Monitoring Technique ◽  
Electronic Fetal Monitoring ◽  
Monitoring Procedure ◽  
Practice Standard ◽  
Physician Liability

AbstractElectronic fetal monitoring (EFM) has been criticized as ineffective, unsafe and costly. Despite existing controversy regarding the risks involved in using EFM, this monitoring procedure continues to be widely employed. In many jurisdictions, in fact, the use of EFM during labor may be considered the customary practice. This Article analyzes the medical and legal issues arising from a physician's use of or failure to use EFM. The Author argues that EFM subjects the mother and the fetus to risks which may be avoided if auscultation, a less intrusive monitoring technique, is employed. The ‘customary practice’ standard of care, the ordinary negligence standard of care, and the ‘best judgment’ and ‘duty to keep abreast’ standards of care are compared and applied to the physician's decision to use EFM. The Author contends that physicians who employ auscultation may not be liable for failing to use EFM; however, physicians who use EFM despite the evidence of its risks may be liable for failing to ‘keep abreast’ or to use their ‘best judgment’ or for negligence. Finally, the Author contends that both physicians and their patients are best protected when the physician elicits the mother's informed consent to employ a particular monitoring technique during labor.

A Prospective Comparison of Selective and Universal Electronic Fetal Monitoring in 34,995 Pregnancies

1987 ◽  
Vol XXXI (3) ◽  
pp. 161???162
Author(s):  
K. LEVENO ◽  
F. CUNNINGHAM ◽  
S. NELSON ◽  
M. ROARK ◽  
M. WILLIAMS ◽  
...  
Keyword(s):  
Fetal Monitoring ◽  
Prospective Comparison ◽  
Electronic Fetal Monitoring

Effect of Oligohydramnios on Fetal Heart Rate Patterns during Term Labor Induction

2018 ◽  
Vol 36 (07) ◽  
pp. 715-722
Author(s):  
Janine S. Rhoades ◽  
Molly J. Stout ◽  
George A. Macones ◽  
Alison G. Cahill
Keyword(s):  
Heart Rate ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Secondary Analysis ◽  
Neonatal Morbidity ◽  
Fetal Monitoring ◽  
Secondary Outcome ◽  
Significant Difference ◽  
Electronic Fetal Monitoring ◽  
Consecutive Term

Objective To estimate the effect of oligohydramnios on fetal heart rate (FHR) patterns in patients undergoing induction of labor (IOL) at term. Study Design Secondary analysis of a prospective cohort study of consecutive term, singleton deliveries from 2010 to 2015. We included all patients who underwent IOL. Our primary outcomes were electronic fetal monitoring (EFM) characteristics in the 2 hours preceding delivery. Outcomes were compared between those induced with oligohydramnios and those induced without a diagnosis of oligohydramnios. Our secondary outcome was composite neonatal morbidity. Logistic regression was used to control for confounders. Results Of 3,787 patients who underwent IOL, 147 had a diagnosis of oligohydramnios and 3,640 were included in the no oligohydramnios group. There was no significant difference in EFM characteristics between the two groups. There was no difference in composite neonatal morbidity. In patients with oligohydramnios, EFM patterns with baseline tachycardia for 30 minutes or greater were significantly associated with composite neonatal morbidity (31.3 vs. 5.3% adjusted odds ratio 8.63, 95% confidence interval 2.18, 34.1]). Conclusion Term patients undergoing IOL with oligohydramnios had EFM patterns that did not differ from their induced peers.

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