Impact of continuous electronic fetal monitoring on birth outcomes in low-risk pregnancies

Birth ◽  
2019 ◽  
Vol 46 (2) ◽  
pp. 311-317 ◽  
Author(s):  
Lisa Heelan-Fancher ◽  
Ling Shi ◽  
Yuqing Zhang ◽  
Yurun Cai ◽  
Ampicha Nawai ◽  
...  
Keyword(s):  
Birth Outcomes ◽  
Fetal Monitoring ◽  
Low Risk ◽  
Electronic Fetal Monitoring ◽  
Continuous Electronic Fetal Monitoring

scholarly journals Healthy Birth Practice #4: Avoid Interventions Unless They Are Medically Necessary

2019 ◽  
Vol 28 (2) ◽  
pp. 94-103
Author(s):  
Judith A. Lothian
Keyword(s):  
United States ◽  
Epidural Analgesia ◽  
Maternity Care ◽  
Fetal Monitoring ◽  
The United States ◽  
Unintended Consequences ◽  
Intravenous Fluids ◽  
Electronic Fetal Monitoring ◽  
Increase Risk ◽  
Continuous Electronic Fetal Monitoring

Maternity care in the United States continues to be intervention intensive. The routine use of intravenous fluids, restrictions on eating and drinking, continuous electronic fetal monitoring, epidural analgesia, and augmentation of labor characterize most U.S. births. The use of episiotomy has decreased but is still higher than it should be. These interventions disturb the normal physiology of labor and birth and restrict women's ability to cope with labor. The result is a cascade of interventions that increase risk, including the risk of cesarean surgery, for women and babies. This paper describes the use and effect of routine interventions on the physiologic process of labor and birth and identifies the unintended consequences resulting from the routine use of these interventions in labor and birth.

Is continuous electronic fetal monitoring useful for all women in labour?

BMJ ◽  
2017 ◽  
pp. j5423 ◽  
Author(s):  
Edward Mullins ◽  
Christoph Lees ◽  
Peter Brocklehurst
Keyword(s):  
Fetal Monitoring ◽  
Electronic Fetal Monitoring ◽  
Continuous Electronic Fetal Monitoring

scholarly journals A mixed-methods evaluation of continuous electronic fetal monitoring for an extended period

2018 ◽  
Vol 97 (12) ◽  
pp. 1515-1523 ◽  
Author(s):  
Alexandra Crawford ◽  
Patrick Anyadi ◽  
Louise Stephens ◽  
Suzanne L. Thomas ◽  
Holly Reid ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Extended Period ◽  
Fetal Monitoring ◽  
Mixed Methods Evaluation ◽  
Electronic Fetal Monitoring ◽  
Continuous Electronic Fetal Monitoring

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.

scholarly journals Use of Continuous Electronic Fetal Monitoring in a Preterm Fetus: Clinical Dilemmas and Recommendations for Practice

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Karolina Afors ◽  
Edwin Chandraharan
Keyword(s):  
Heart Rate ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Scientific Evidence ◽  
Preterm Births ◽  
Fetal Monitoring ◽  
National Guidelines ◽  
Physiological Control ◽  
Electronic Fetal Monitoring ◽  
Continuous Electronic Fetal Monitoring

The aim of intrapartum continuous electronic fetal monitoring using a cardiotocograph (CTG) is to identify a fetus exposed to intrapartum hypoxic insults so that timely and appropriate action could be instituted to improve perinatal outcome. Features observed on a CTG trace reflect the functioning of somatic and autonomic nervous systems and the fetal response to hypoxic or mechanical insults during labour. Although, National Guidelines on electronic fetal monitoring exist for term fetuses, there is paucity of recommendations based on scientific evidence for monitoring preterm fetuses during labour. Lack of evidence-based recommendations may pose a clinical dilemma as preterm births account for nearly 8% (1 in 13) live births in England and Wales. 93% of these preterm births occur after 28 weeks, 6% between 22–27 weeks, and 1% before 22 weeks. Physiological control of fetal heart rate and the resultant features observed on the CTG trace differs in the preterm fetus as compared to a fetus at term making interpretation difficult. This review describes the features of normal fetal heart rate patterns at different gestations and the physiological responses of a preterm fetus compared to a fetus at term. We have proposed an algorithm “ACUTE” to aid management.

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