[Modality of fetal heart monitoring during labor (continuous or intermittent), telemetry and central fetal monitoring].
Fetal heart monitoring during labor is almost systematic today. Continuous monitoring decreases neonatal convulsions, but increases caesarean section and forceps deliveries without impact on long term neonatal prognosis. Overall, there is no proved impact of cardiac fetal monitoring (continuous or intermittent) on perinatal mortality. The most recent study shows neonatal benefits of continuous monitoring associated with an overall increase of caesarean section rate. Continuous fetal monitoring has a better sensitivity to detect acidosis. Many arguments for continuous fetal monitoring will be reported in this review. In specific conditions, intermittent fetal auscultation can be realised, but in current practice such conditions can rarely be applied. Telemetry has been poorly evaluated to date but experiences are currently undertaken. Central fetal monitoring does not improve neonatal issue but could increase caesarean section rate. Central of fetal monitoring could help in the organisation and the conservation of fetal heart monitoring.
Bretelle
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F
Service de Gynécologie Obstétrique, Hôpital Nord, Chemin des Bourrely, Université Aix-Marseille-II, Marseille Cedex 20, France. florence.bretelle@ap-hm.fr
Le Du
R
R
Foulhy
C
C
D000138:Acidosis / Q000175:diagnosis; D002585:Cesarean Section / Q000706:statistics & numerical data; D005113:Extraction, Obstetrical / Q000379:methods; D005260:Female; D005323:Fetal Monitoring / Q000009:adverse effects / Q000379:methods*; D006340:Heart Rate, Fetal; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007743:Labor, Obstetric; D009772:Obstetrical Forceps; D011247:Pregnancy; D013686:Telemetry