Table 3. Electronic Fetal Monitoring Versus Auscultation, Maternal Mordibidy and Mortality

Reference, Date, SiteVintzileos et al. (1993), GreeceShy et al. (1990), U.S. and British ColumbiaLeveno et al. (1986), TexasMahomed et al. (1994), ZimbabweWood et al. (1981), AustraliaMacDonald et al., (1985) Dublin
Abnormal FHR Patterns EFM=175 (23.4%) IA=73 (10.7%) Sign. higher in EFM vs. IA gr.EFM=21/82 (26%) IA=15/91 (16%) No Stat AnalysisTotal patient group: Univ. EFM=12% Selec. EFM=10% Sign. higher in univ. vs. selec. EFM gr.

For 14,618 low-risk pregnancies: Univ. EFM=551 (7.6%) Selec. EFM=196 (2.7%) Sign. higher in univ. vs. selec. EFM gr.
EFM=172 (54%) Sign. higher in EFM vs. IA gr. Dop ultra=100 (34%) Sign. higher in EFM vs. IA gr. Pinard steth=47 (15%) Sign. higher in EFM vs. IA gr. IA=28 (9%)N/AFHR on EFM tracing: EFM=169/6474 (2.6%) IA=6/6490 (0.1%) Sign. higher in EFM vs. IA gr.

FHR by IA: EFM=4/6474 (0.1%) IA=43/6490 (0.6%) Sign. lower in EFM vs. IA gr.
Oxytocin Administration EFM=508 (68.1%) IA=308 (45.1%) Sign. higher in EFM vs. IA gr.EFM=54% of 82 IA=66% of 91 No Stat AnalysisUniv. EFM=7% Selec. EFM=7% NSN/AN/A(Among the patients accrued during the first phase of study) EFM=1122/4987 (22.5%) IA=1188/4999 (23.8%) NS
Premature Rupture of Membranes EFM=127 (17%) IA=104 (15.2%) NSEFM=68% of 82 IA=54% of 91 No Stat AnalysisN/AN/AN/AN/A
Surgical Intervention for Nonreassuring FHR Patterns (TOTAL) EFM=84 (11.2%) IA=33 (4.8%) Sign. higher in EFM vs. IA gr.N/AN/AN/AEFM=138/145 (31%) IA=111/482 (23%) Sign. higher in EFM vs. IA gr.N/A
Cesarean Section for Fetal Distress EFM=40 (5.3%) IA=16 (2.3%) Sign. higher in EFM vs. IA gr.EFM=4/82 (5%) IA=3/91 (3%) No Stat AnalysisTotal patient group: Univ. EFM= 1993/17,586 (11%)Selec. EFM=1777/17,409 (10.2%) Sign. higher in univ. vs. selec. EFM gr.

14,618 low-risk pregnancies: Univ. EFM= 64 (0.9%) Selec. EFM=28 (0.4%) Sign. higher in univ. vs. selec. EFM gr.
Proportion of cesarean section patients whose indication was fetal distress: EFM=56/89 (63%) Dop ultra=51/76 (67%) Pinard steth=13/32 (41%) IA=19/46 (41%)EFM=18/ 445 (4.0%) IA=10/482 (2.1%) NSFor fetal distress: EFM=25/6474 (0.4%) IA=10/6490 (0.2%) NS

For FHR abnormality and low fetal scalp blood pH: EFM=3.6/1000 IA=1.1/1000 Sign. higher in EFM vs. IA gr.
Maternal Hospital Stay (Days) 4.3 ± 1.1 versus 4.3 ± 1.2 NSN/AN/AN/AN/AN/A
Maternal Morbidity EFM=35 (4.6%) IA=31 (4.5%) (including infection and transfusions) NSN/AN/AEFM=31 (10%) Dop ultra=28 (9%) Pinard steth=25 (8%) IA=21 (7%) NSN/APuerperal (after childbirth) fever: EFM=19.6/1000 IA=16.7/1000 NS

In 2716 mothers analyzed separately, genital tract infection was significantly more frequent in the EFM compared to IA monitored patients.
Total Cesarean Section For other than fetal distress: EFM=31 (4.1%) IA=43 (6.3%) NSIndication for delivery not considered: EFM=10/82 (12%) IA=13/91 (14%) NSN/AEFM=89 (28%) Sign. higher in EFM vs. IA gr. Dop Ultra=76 (24%) Sign. higher in EFM vs. IA gr. Pinard steth=32 (10%) (NS versus IA) IA=46 (15%)N/AEFM=158/6474 (2.4%) IA=144/6490 (2.2%) NS

From: Fetal Heart Rate Assessment During Labor

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Minnesota Health Technology Assessments [Internet].
Minnesota Health Technology Advisory Committee.
St. Paul (MN): Minnesota Department of Health; 1995-2001.

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