Intrapartum electronic fetal heart rate assessment in low and moderate risk patients: intermittent or continuous monitoring

ABSTRACT

Over a period of 12 months, pregnant women [1008 women] with low or moderate risk factors were studied to compare the intermittent versus continuous fetal heart rate monitoring during first stage of labour for early detection of fetal distress, as well as mode of delivery and neonatal outcome. 503 women were randomly allocated to continuous monitoring [C-group] and 508 women to intermittent monitoring [I-group]. There was no significant difference between the two groups in the incidence of abnormal FHR tracing, however suspicious FHR tracing was significantly [P < 0.05] more frequent in C group. In I-group, FHR monitoring was performed for 52.3% of first stage time, compared with 88.5% in the C-group [P < 0.001]. Ventose or forceps deliveries were significantly [P < 0.05] more in C group than in I group. The incidence of cesarean section for fetal distress was non significantly different [1.4% and 1.8% in I group and C-group respectively]. There was no significant differences in the neonatal outcome as regard the Apgar scoring, umbilical artery blood pH, admission to neonatal care unit or neonatal death. In pregnant women with mild or moderate risk factors, intermittent FHR monitoring can be considered safe and effective, and at the same time less costy when compared to continuous monitoring