Electronic fetal monitoring: A bridge too far

摘要

The most common obstetrical procedure in the United States is electronic fetal monitoring (EFM) during labor. Approximately 85% of the 4,000,000 annual births are EFM monitored. EFM is the standard of care in virtually every community. Hospitals have invested multiple millions of dollars in electronic fetal monitoring since its acceptance into clinical practice in the late 1960s. Hospitals and physicians have billed and been paid many millions of dollars for EFM use. Despite its ubiquity and acceptance in daily clinical obstetrical practice, there are and always have been some important, esoteric EFM secrets: its scientific foundation is feeble; inter-observer/intra-observer reliability is poor