CONTEXT Numerous randomized controlled trials have demonstrated limited efficacy of intrapartum fetal heart rate monitoring in improving fetal outcome. A potential reason is the wide variability in clinical decision making seen with its use. Standardizing management of variant intrapartum fetal heart rate tracings may reduce this variability and lead to improvement in fetal outcome. OBJECTIVE...

Some intrapartum care practices promote vaginal birth, whereas others may increase the risk for cesarean section. Electronic fetal monitoring and use of the Friedman graph to plot and monitor labor progress are associated with increasing the cesarean section rate. Continuous one-to-one support and midwifery management are associated with lower cesarean section rates. This article reviews the ev...

Since its inception, many have questioned the utility of electronic fetal heart rate (FHR) monitoring. However, it arrived without the benefit of clear, standard nomenclature, leading to difficulty interpreting studies regarding its benefit. In 2008, the National Institute of Child Health and Human Development (NICHD) developed standard nomenclature for interpreting eFHR tracings. Understanding...

Obstetric intervention originally consisted of extraction of the baby, usually by the breech, to save the mother's life in obstructed labour. Forceps, introduced in the 17th century, were later refined by men-midwives like William Smellie. In Victorian times, Simpson championed chloroform anaesthesia, Lister pioneered antisepsis, and caesarean section was introduced. In 1935, however, Britain's...

Introduction; Fetal monitoring of instantaneous heart rate (IHR) is one of major advances in recent perinatal medicine. It is widely accepted that changing pattern of fetal IHR associated with uterine contraction will reflect fetal well or ill being. Uterine contraction produces temporary hypoxia to the fetus and apnea does the same to the neorlate. Therefore we analysed changing patterns of ne...