![]() The result is a quantitative 8-point metric, with each variable being weighted equally in version 1.0. Our group has developed a modified approach called the “Fetal Reserve Index” that contextualizes the findings of electronic fetal monitoring by formally including the presence of maternal, fetal, and obstetrical risk factors and increased uterine contraction frequencies and breaking up the tracing into 4 quantifiable components (heart rate, variability, decelerations, and accelerations). Even key electronic fetal monitoring opinion leaders admit that this goal has yet to be achieved. ![]() Multiple attempts have aimed at enhancing its ability to accurately distinguish babies at risk of in utero injury from those who are not and to do this in a timely manner so that appropriate intervention can be performed. Electronic fetal monitoring is clearly a screening test. Most at-risk cases produced healthy babies, resulting in part from considerable confusion as to the differences between diagnostic and screening tests. With the routine use of electronic fetal monitoring, the cesarean delivery rate increased from 30% at present. ![]() Initially successfully designed for stillbirth prevention, there was hope to also include prediction and prevention of fetal acidosis and its sequelae. Electronic fetal monitoring, particularly in the form of cardiotocography, forms the centerpiece of labor management.
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