Routine use
of electronic fetal monitoring is not in the best interests of either.»
He believes we should not extend the use
of electronic fetal monitoring to women at low risk, nor should we continue to use it as often as we currently do.
«Limiting the use
of electronic fetal monitoring to the very highest risk labours may be justifiable, but even then the balance of benefits and harms is uncertain,» he adds.
They blame this increase on the introduction
of electronic fetal monitoring, and the decrease in breech births and forceps births.
The rate
of electronic fetal monitoring, C - sections, forceps or vacuum delivery, and epidurals were also much lower with home births.
This dramatic increase was a result of several changes in the practice environment, including the introduction
of electronic fetal monitoring and a decrease in operative vaginal deliveries and attempts at vaginal breech deliveries (8 — 11).
In the era
of electronic fetal monitoring, among neonates born to nulliparous women, adverse neonatal outcomes generally have not been associated with the duration of the second stage of labor.
In the United States, Canada, and recently England, major reviews of the evidence have concluded that electronic fetal monitoring should be reserved for high risk pregnancies.18 Use
of electronic fetal monitoring has increased worldwide, however, in both low and high risk groups.
Continuous cardiotocography (CTG) as a form
of electronic fetal monitoring (EFM) for fetal assessment during labor.
Not exact matches
Many practitioners and hospitals prefer that laboring women be attached to an
electronic fetal monitor continuously throughout active labor and birth regardless
of risk factors.
Moreover, in out -
of - hospital settings, there is likely less antepartum testing and no continuous
electronic intrapartum
fetal monitoring, both
of which may have affected adverse outcomes.
There are two types
of fetal monitoring used: Electronic Fetal Monitoring (EFM) and also Manual Ausculta
fetal monitoring used: Electronic Fetal Monitoring (EFM) and also Manual Aus
monitoring used:
Electronic Fetal Monitoring (EFM) and also Manual Ausculta
Fetal Monitoring (EFM) and also Manual Aus
Monitoring (EFM) and also Manual Auscultation.
I have read hundreds
of studies that give me confidence to say — no, don't cut the cord right away or no, please only
monitor the baby intermitently (
electronic fetal monitors DO NOT statisitically save babies, have a high false positve rate, and are associated with higher rates
of pain medication, pitocin, and C section).
Use
of inappropriate
electronic fetal monitoring perhaps illustrates the extent and pervasiveness
of medicalised practice in Western maternity care.
* induction
of labour (starting your labour artificially) * augmentation
of labour (speeding up your labour) * artificial rupture
of the membranes (ARM) * using medication for pain relief *
electronic fetal monitoring — external CTG or internal
fetal scalp * managed third stage
of labour (delivering the placenta) * coached pushing * restricted birthing positions * immediate cord clamping * seperation
of mother and baby in surgery / recovery
The signs
of oxygen deprivation would likely have been diagnosed with
electronic fetal monitoring.
But
electronic fetal monitoring provides a wealth
of information that can not be obtained by listening, and that allows for a more comprehensive view
of fetal well being.
A prospective comparison
of selective and universal
electronic fetal monitoring in 34 995 pregnancies.
Electronic fetal monitors limit the movement
of the mother, and this can slow labour down.
You'll also receive an IV, as well as continuous
electronic fetal monitoring of each baby for the duration
of your labor.
However know that throughout the process your baby will be continuously
monitored via
electronic fetal monitoring, which will help your practitioner to assess how he or she is dealing with the stress
of induced labor and take steps to protect both
of you.
In a vaginal breech delivery,
electronic fetal monitoring will be used to
monitor the baby's heartbeat throughout the course
of labor.
There is some evidence that the use
of continuous
electronic fetal monitoring may lead to increased false positives for
fetal hypoxemia and to resulting caesarean sections.21, 22
Ninety - four percent
of the women had
electronic fetal monitoring (93 %
of those women were
monitored continuously).
This includes the availability
of blood and fresh - frozen plasma for transfusion; anesthesia, radiology, ultrasound,
electronic fetal heart rate
monitoring and laboratory services available on a 24 - hour basis; resuscitation and stabilization
of all inborn neonates; nursery; and other services that are not available in the home setting.
Their particular concern is the «trends towards excessive, unnecessary, or inappropriate use
of obstetric interventions» (p. 2178), including unnecessary ultrasound examinations, routine
electronic fetal monitoring, routine episiotomy, high rates
of labour induction and augmentation, and non-medically indicated CS.
What is most unsettling is that many
of the heart rate abnormalities are easily resolved with simple measures such as position changes, which the mother is hindered from doing while attached to the
electronic fetal monitor.
Compared with women who planned a hospital birth with a midwife or physician in attendance, those who planned a home birth were significantly less likely to experience any
of the obstetric interventions we assessed, including
electronic fetal monitoring, augmentation
of labour, assisted vaginal delivery, cesarean delivery and episiotomy (Table 3).
To assess the frequency and length
of your contractions as well as your baby's heart rate, you'll need to have continuous
electronic fetal monitoring during an induced labor.
As an example, consider the intervention
of continuous
electronic fetal monitoring.
And best
of all, breathing is the one coping strategy that can't be taken away from you — even if you're stuck in bed attached to an
electronic fetal monitor and intravenous fluids.
One
of the more widely used methods
of monitoring is
electronic fetal heart rate (FHR)
monitoring.
They acknowledge that
electronic fetal monitoring increases the rate
of instrumental delivery (such as use
of forceps) and caesarean section, but argue that increased intervention «may not be entirely undesirable, given that appropriately timed intervention is likely to avoid neonatal hypoxia, seizures, and perinatal death.»
Electronic fetal monitoring is often used during labour to detect unborn babies at risk
of brain damage (neonatal encephalopathy) from a lack
of oxygen (hypoxia).
Given that
electronic fetal monitoring does not prevent perinatal deaths, «the excess
of subsequent deaths caused by the increased risk
of caesarean section is a major concern.»
Electronic fetal monitoring increases the risk
of women having a caesarean section, which is not a benign operation, he writes.
He argues that «most
of the fetuses identified as being at risk
of hypoxia are not» and highlights a review
of trial data for nearly 37,000 women that found no difference in perinatal mortality between labours with
electronic fetal monitoring versus intermittent auscultation.
But Peter Brocklehurst, Professor
of women's health at Birmingham Clinical Trials Unit, says «the more we use
electronic fetal monitoring, the more harm we do, with little evidence
of benefit.»
Obstetrics specialists, Edward Mullins and Christoph Lees, at Imperial College London say that failure to use continuous
electronic fetal monitoring «amounts to a misguided blinding
of the clinician to the clinical state
of the fetus.»
In 2005, the Food and Drug Administration granted conditional approval
of the STAN S31 device for use in addition to the
electronic fetal heart rate
monitoring.
Electronic fetal monitoring is used in more than 85 percent
of the 4 million live births in the U.S. every year.
If the baby is showing distress on the
electronic fetal heart rate
monitor, reasonable care requires the nurse to discontinue the use
of Pitocin.