The advantages and risks of feto-maternal monitoring.

Abstract

Intrapartum feto-maternal monitoring (f.-m. m.), which was first introduced by CALDEYRO-BARCIA [12] and SALING [42], can be regarded as the foundation of perinatal medicine. Its use not only reduced perinatal mortality repidly, but also increased our knowledge of the pathology and physiology of labor and their influence on maternal as well as fetal metabolism. In spite of this, critical comments regarding the dangers and even the need for f.-m. m. were published recently [25]. These unexpected requests to look at birth again as a natural, physiological process, making machines, and even delivery rooms unnecessary, raised doubts regarding the advantages of f.-m. m. The criticism even went so far as to state that f.-m. m. influences the physiological condition of a newborn child unfavorably. It would seem that the pendulum has swung back to what is described as natural childbirth, returning us to the days when PINARD's stethoscope was regarded as a modern, sufficient and effective Instrument in supervising the well-being of a fetus in labor. In 1979 DUNN [18] published a list of the dangers of f.-m. m. without giving exact figures of their frequency, which shocked those who have introduced this technique in their own delivery rooms. It was this paper which encouraged us to collect data regarding the benefits as well as the hazards of f.-m. m. on a large scale, to answer most of the questions raised by DUNN [18]. We also intend to give exact figures calculated from a large number of cases monitored in various centers with different degrees of experience.