The Continuous Use of Electronic Fetal Monitors — 99.8% false positive rate, unable to prevent cerebral palsy

by faithgibson on December 29, 2012

in Contemporary Childbirth Politics

The Continuous Use of Electronic Fetal Monitors — 99.8% false positive rate, unable to prevent cerebral palsy

In July 2003 ACOG’s Task Force on Neonatal Encephalopathy & Cerebral Palsy concluded that the obstetrical profession was mistaken about the ability of continuous electronic monitoring and liberal use of cesarean section to reduce the rate of cerebral palsy and other neurological disabilities. [‘neonatal encephalopathy’ is birth-related brain damage] In noting the failure of EFM and cesareans to prevent these complications, the report stated that:

“Since the advent of fetal heart rate monitoring, there has been no change in the incidence of cerebral palsy. …. The majority of newborn brain injury does not occur during labor and delivery. Instead, most instances of neonatal encephalopathy and cerebral palsy are attributed to events that occur prior to the onset of labor.”

This ACOG task force report had the endorsement and support of six major federal agencies and professional organizations, including the Center for Disease Control & Prevention (CDC), the March of Dimes and the obstetrical  professions in Australia, New Zealand and Canada. It is described as the “most extensive peer-reviewed document on the subject published to date.”

The September 15, 2003 edition of Ob.Gyn.News stated that:

“The increasing cesarean delivery rate that occurred in conjunction with fetal monitoring has not been shown to be associated with any reduction in the CP rate……

Only 0.19% of all those in the study had a non-reassuring fetal heart rate pattern…. If used for identifying CP risk, a non-reassuring heart rate pattern would have had a 99.8% false positive rate….” [emphasis added]

An August 15, 2002 report in Ob.Gyn.News stated that:

…performing cesarean section for abnormal fetal heart  rate pattern in an effort to prevent cerebral palsy is likely to cause as  least as many bad outcomes as it prevents.”

…. A physician would have to perform 500 C-sections* for multiple late decelerations or reduced beat-to-beat variability to prevent a single case of cerebral palsy. [* ‘numbers needed to treat’] emphasis added

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