Predictors of intrapartum fetal distress: The role of electronic fetal monitoring

1979 ◽  
Vol 135 (3) ◽  
pp. 287-291 ◽  
Author(s):  
Frederick P. Zuspan ◽  
E.J. Quilligan ◽  
Jay D. Iams ◽  
Herman P. van Geijn
Keyword(s):  
Fetal Monitoring ◽  
Fetal Distress ◽  
Electronic Fetal Monitoring

Antenatal care, obstetrics, and fetal medicine

2017 ◽  
Author(s):  
Grenville Fox ◽  
Nicholas Hoque ◽  
Timothy Watts
Keyword(s):  
Breech Presentation ◽  
Fetal Monitoring ◽  
Fetal Distress ◽  
Maternal Diabetes ◽  
Blood Sampling ◽  
Multiple Birth ◽  
Fetal Blood ◽  
Fetal Blood Sampling ◽  
Electronic Fetal Monitoring ◽  
Chorionic Villous Sampling

This chapter contains details of methods used for screening and diagnosis of fetal anomalies using antenatal blood tests, ultrasound scanning, chorionic villous sampling, amniocentesis, and fetal blood sampling. There are sections on pre-existing maternal diseases presenting risks to the fetus including maternal diabetes, systemic lupus erythematosus, thrombocytopenia, and neuromuscular disease, as well as those specific to pregnancy—pre-eclampsia, HELLP syndrome, and eclampsia. Intrauterine growth restriction and monitoring is covered in detail. The increased fetal risks of multiple birth due to twin-to-twin transfusion syndrome and other pregnancy complications are described, with detail on oligohydramnios, polyhydramnios, antepartum haemorrhage, preterm prelabour rupture of membranes, cord prolapse, preterm labour, and breech presentation. Intrapartum fetal assessment using electronic fetal monitoring and fetal blood sampling to diagnose fetal distress is covered to enable health professionals involved in care of the newborn to understand events which may have resulted in a baby born in poor condition.

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.

The Role of the Legal System in the Cesarean Childbirth Controversy

1980 ◽  
Vol 1 (10) ◽  
pp. 1-8
Author(s):  
Judy Miller
Keyword(s):  
Birth Rate ◽  
Nursing Practice ◽  
Fetal Monitoring ◽  
Fetal Distress ◽  
The United States ◽  
Cesarean Birth ◽  
Threefold Increase ◽  
Cesarean Births ◽  
Patient Advocates

The threefold increase in the cesarean birth rate in the United States during the last ten years has caused much concern among the general public and some medical professionals. Nurses particularly have shared this concern as the scope of nursing practice has expanded and nurses increasingly see themselves as patient advocates. Obviously, not all cesarean births are unwarranted. The procedure may be indicated if there is maternal or fetal risk during labor, if attempted induction of labor fails, and/or if an emergency mandates immediate delivery which is not possible or suitable vaginally.A recent review of over 1,000 U.S. and foreign research articles cites three general reasons for the increasing cesarean birth rate: use of the operation for breech presentations and for repeat sections; the need for early intervention due to fetal distress as determined by the increasing use of fetal monitoring; and physicians' fear of malpractice suits. The first two reasons are matters of medical controversy.

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.

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