Abstract
The objective of the study was to examine the clinical impact of specific fetal monitoring-related practices during induced labor. This was a prospective, nonrandomized study. We studied 14,398 women undergoing oxytocin induction of labor. A decrease in the infusion rate of oxytocin in the face ofspecified category II fetal heart rate tracings was associated with asignificantly reduced rate of neonatal intensive care unit admission (3.8% vs 5.2%, P= .01) and Apgar score less than 7 at 1 and 5minutes (4.9% vs 6.4%, P= .01, 0.6% vs 1.1%, P= .04). Compliance with an in-use checklist was associated with both a reduction in the rate of neonatal intensive care unit admission (2.9vs4.4, P= .00) and a reduction in the cesarean delivery rate (15.8% vs 18.8%, P= .00). Electronic fetal heart rate monitoring improves neonatal outcomes when unambiguous definitions of abnormal fetal heart rateand tachysystole are coupled with specific interventions. Utilization of a checklist for oxytocin monitoring is associated with improved neonatal outcomes and a reduction in the cesarean delivery rate.
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