Abstract
Electronic fetal monitoring (EFM) is used extensively throughout the UK despite a continued debate about its efficacy and its effectiveness. This paper reviews the evidence to date, examines the link between EFM and fetal outcome, discusses fetal sensitivity and specificity issues and looks at the intervention/benefit ratio of EFM, including the risks of caesarean section. It concludes that EFM should be discontinued for women at low obstetric risk because there is no substantive evidence that it reduces perinatal mortality or the incidence of cerebral palsy. It does, though, result in higher Caesarean section rates. There is also no evidence to date that EFM educational materials reduce the false positive rate of EFM Interpretation. However, they should ensure a greater consistency and as long as participants apply the tests referred to in this paper, they continue to be of some value.
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