How does electronic fetal heart rate monitoring affect labor and delivery outcomes?

Abstract

Continuous electronic fetal monitoring (EFM) reduces the risk of neonatal seizure by 50% compared with intermittent auscultation (IA) (strength of recommendation [SOR]: A, systematic review of randomized controlled trials [RCTs]). EFM increases the incidence of cesarean section by 66% and the incidence of operative vaginal delivery by 16% (SOR: A, systematic review of RCTs). It has no effect on the rates of cerebral palsy or neonatal mortality (SOR: A, systematic review of RCTs). An estimate from a Cochrane meta-analysis suggests that a cohort of 628 women receiving EFM could expect to experience 1 less neonatal seizure and 11 more cesarean sections compared with IA controls.