For those who think electronic fetal heart rate monitoring (EFM) is unnecessary during labor and delivery, think again. Although this technology has been described by opponents as difficult to use, unreliable, and unnecessary, the facts prove otherwise. In actuality, use of EFM may save the lives of many newborns.
Researchers at the University of Wisconsin conducted a major study on this issue. Looking over 1.7 million births in the US is n 2004, they found that EFM had consistently positive effects. Risk of infant mortality was lowered to an adjusted relative risk of 0.75 with use of EFM. There was also lower risk of early neonatal mortality (adjusted relative risk 0.50). In low-risk pregnancies, researchers saw decreed risk for low Apgar scores; in high-risk pregnancies, they saw decreed risk of neonatal seizures. All in all, the results were convincing: use of electronic fetal heart rate monitoring during labor and delivery is unambiguously beneficial to infant and mother.
EFM is used during pregnancy, labor, and delivery to track the heart rate of the fetus and the strength and duration of your contractions. It can provide minute-by-minute information on the status of the fetus, as heart rate can be a good way to tell whether it is under stress or not. When problems do occur, EFM can provide insight into the baby's reaction and its ability to tolerate the stress being put on it.
There are two types of electronic fetal monitors: internal and external. In external monitoring, the mother wears a belt with sensors. These record the baby's heart rate and the duration of the mother's contracts. The information is often printed on a chart. Internal monitoring is only performed close to delivery. For this, a sensor is inserted into the uterus and attached to the baby's scalp. Internal monitoring is more accurate but does come with somewhat heightened risks for the mother.
Given the data supporting the benefits of EFM, it appears that instead of questioning the technology, critics should focus their attention on helping doctors become better trained in interpreting the EFM output. In the past, many doctors and nurses have not received adequate training in EFM tracings, and terminology has not been standardized, leading to confusion and miscommunication. It has recently been suggested that computer-assisted interpretation could have improved the reliability and effectiveness of EFM. Whether the solution lies in computer assistance or improved training programs, EFM has proved its effectiveness and critiques need to acknowledge its power in preventing infant mortality and morbidity.