Foetal heart rate monitoring--present lessons and future developments.

JUST as the first detailed description of the foetal heart sounds (Le Jumeau de Kergaradec, 1822) eventually led to the view that foetal bradycardia might indicate danger to the foetus (Von Winckel, 1903) and to the present routine practice of periodic auscultation during labour, so the first reported foetal electrocardiogram (Cremer, 1906) has been followed by efforts to develop automatic methods of monitoring the foetal heart (Hon, 1960). The shortcomings of intermittent auscultation as a means of detecting foetal distress or of predicting the condition of the baby at and after delivery prompt the following questions: Is electronic monitoring any better ? Is it now ready for routine use in our labour wards Has research in this field provided any lessons which can be applied now to routine practice ? How are future advances likely to help clinical management ? In attempting to make some answer to these questions, the writer draws heavily on recent experience as a member of Dr. Edward H. Hon's research group in Los Angeles and at Yale University. In addition to obtaining practical training in Hon's methods, his unrivalled library of tracings from more than 1,000 fully monitored labours was studied in detail.