Intrapartum electronic fetal monitoring in low-risk pregnancies

The value of fetal monitoring in low-risk pregnancies was evaluated in 4278 deliveries, 85% of all low-risk patients delivered in 1977 and 1978 at the University Hospital of Lund. An irreproachable tracing was recorded in less than half the cases. Fetal heart rate changes demanding scalp pH measurements or operative intervention for fetal distress occurred in about 10% of all deliveries. In only 30 patients (0.7%) was cesarean section performed for fetal distress. No intrapartal deaths occurred. The perinatal mortality (antenatal deaths excluded) was 0.14%. Only 3 of 1000 newborns had an Apgar score less than 7 at 5 minutes. The reported negative implications of routine fetal monitoring, such as overdiagnosis of fetal distress, cannot be verified in this study when electronic fetal monitoring and pH measurements are combined. The excellent fetal outcome suggests benefits from routine electronic fetal monitoring even in low-risk pregnancies.