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Most controlled studies indicate that intrapartum electronic fetal heart monitoring (EFM) does not reduce neonatal mortality when compared with intermittent auscultation. A large randomized trial in Greece challenges that conclusion.
The trial involved 1428 pregnant women with singleton fetuses of at least 26 weeks' gestation without known congenital abnormalities. When compared with women receiving intermittent auscultation, those monitored by EFM had longer labors and more alarming fetal heart-rate patterns, and received more surgical interventions and more oxytocin for labor augmentation or induction. Neonatal outcomes such as Apgar scores, the need for resuscitation, and intensive-care requirements did not differ between the two groups. …