Haverkamp follow-up on his 1st EFM trial with abstract and links for 21 reference

by faithgibson on September 20, 2020

 

American Journal of Obstetrics and Gynecology

Volume 125, Issue 3, 1 June 1976, Pages 310-320 Transactions of the Forty-third Annual Meeting of the Central Association of Obstetricians and Gynecologists

The evaluation of continuous fetal heart rate monitoring in high-risk pregnancy

Abstract

Intrapartum electronic fetal heart rate monitoring of the high-risk obstetric patient is thought to improve the perinatal outcome. A prospective randomized study of 483 high-risk obstetric patients in labor was carried out comparing the effectiveness of electronic fetal monitoring with auscultation of fetal heart tones.
The infant outcome was measured by neonatal death, Apgar scores, cord blood gases, and neonatal nursery morbidity.
There were no differences in the infant outcomes in any measured category between the electronically monitored group and the auscultated group.
The cesarean section rate was markedly increased in the monitored group (16.5 vs. 6.8 per cent in the auscultated patients).
The presumptive benefits of electronic fetal monitoring for improving fetal outcome were not found in this study.

The Journal of Pediatrics

Volume 97, Issue 1, July 1980, Pages 103-107

Pediatric follow-up of a randomized controlled trial of intrapartum fetal monitoring techniques

A controlled prospective study was conducted to evaluate possible effects of the use of three intrapartum fetal monitoring techniques on the offspring of high-risk mothers in labor after at least 34 weeks’ gestation.
Six hundred and ninety women were randomly assigned to one of the three monitoring groups: auscultation alone, electronic monitoring alone, and electronic monitoring with option to obtain fetal scalp pH.
There were no significant differences among the three groups of offspring with respect to neonatal mortality or morbidity, Apgar scores, cord blood gas values, or Brazelton examinations at ages 2 to 3 days.
Assessment of the infants at 9 months revealed no significant differences in their growth and development as assessed by physical examination, Bayley Scales of Infant Development, and Milani-Comparetti tests. The frequency of delivery by cesarean section was significantly higher in the electronically monitored group than in the auscultated group. This study failed to show beneficial effects of electronic fetal monitoring over auscultated monitoring for high-risk but relatively mature fetuses.

References

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Intensive care of the high risk fetus in labour.
J Obstet Gynaecol Br Comm. 1971; 78: 865
Paul RH, Clinical fetal monitoring. Experience on a large clinical service.
Am J Obstet Gynecol. 1972; 113: 573
Quilligan E, Paul R
Fetal monitoring: Is it worth it?.
Obstet Gynecol. 1975; 44: 96
(Personal communication) Wenberg J
Changing patterns of perinatal risk, medical care, and mortality in Vermont, 1970–1975.
1978
Paul RH, Huey JR, Yaeger CF
Clinical fetal monitoring, its effect on Cesarean section rate and perinatal mortality: Five year trends.
Postgrad Med. 1977; 61: 160
Neutra RR, Fienberg SE, Greenland S, Friedman EA
Effect of fetal monitoring on neonatal death rates.
N Engl J Med. 1978; 299: 324
Haverkamp AD, Orleans M, Langendoerfer S, McFee J, Murphy J
A controlled trial of the differential effects of intrapartum fetal monitoring.
Am J Obstet Gynecol. 1979; 134: 399
Check WA
Electronic fetal monitoring: How necessary?.
JAMA. 1979; 241: 1772
ACOG Committee on Obstetrics
Maternal and fetal medicine: Committee comments on EFM controversy.
ACOG Newsletter. 1979; 23: 1
Goodwin JW, Dunne JT, Thomas BW
Antepartum identification of the fetus at risk.
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The Brazelton Neonatal Behavioral Assessment Scale (BNBAS).
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in: The Psychological Corporation, New York1969
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Routine development examination in normal and retarded children.
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The evaluation of continuous fetal heart rate monitoring in high-risk pregnancy.
Am J Obstet Gynecol. 1976; 125: 310
Renou P, Chang A, Anderson I, Wood C
Controlled trial of fetal intensive care.
Am J Obstet Gynecol. 1976; 126: 470
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An assessment of continuous fetal heart rate monitoring in labor.
Am J Obstet Gynecol. 1978; 131: 526
Ledger WJ
Complications associated with invasive monitoring.
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The mother-newborn relationship: Limits of adaptability.
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