ABSTRACT
Thirty years ago, the inaugural issue of The Journal of Perinatal & Neonatal Nursing was published and the entire perinatal portion of the journal was devoted to electronic fetal monitoring (EFM). This article provides a historical perspective on EFM in perinatal care since the 1980s by exploring the similarities and differences of the state of the science presented in that first issue. Both EFM and intermittent auscultation are discussed.
Subject(s)
Cardiotocography , Perinatal Care , Cardiotocography/history , Cardiotocography/methods , Female , Heart Auscultation/methods , Heart Rate, Fetal , History, 20th Century , History, 21st Century , Humans , Perinatal Care/history , Perinatal Care/methods , Pregnancy , PublishingSubject(s)
Cardiotocography/history , Heart Rate, Fetal , Labor, Obstetric/history , Obstetrics/history , Artificial Intelligence , Female , Fetal Hypoxia/diagnosis , Fetoscopes/history , History, 18th Century , History, 19th Century , History, 20th Century , History, 21st Century , Humans , Observer Variation , Obstetrics/instrumentation , PregnancyABSTRACT
Electronic fetal monitoring (EFM) using cardiotocography is a common tool used during labor and delivery for assessment of fetal well-being. It has largely replaced the use of intermittent auscultation and fetal scalp pH sampling. However, data suggesting improved clinical outcomes with the use of EFM are sparse. In this review, the history of EFM is revisited from its inception in the 1960s to current practice, interpretations, and future research goals.
Subject(s)
Cardiotocography/history , Auscultation , Birth Injuries/prevention & control , Cardiotocography/methods , Cardiotocography/trends , Delivery, Obstetric , Female , Fetal Distress/diagnosis , Forecasting , Heart Rate, Fetal , History, 20th Century , History, 21st Century , Humans , Labor, Obstetric , Pregnancy , Pregnancy Complications/diagnosisABSTRACT
The technology of intrapartum surveillance made rapid strides from the 1960s through the 1980s but then stagnated as increasing resort to caesarean section was made rather than improving measures of fetal condition and labour progress. However, despite caesarean section rates commonly over 30%, medicolegally expensive mistakes continue to be made because it is difficult to teach clinicians to make reliable use of existing technology. It may be that as with aircraft navigation, the safest solution is to replace human judgement with the obstetric equivalent of automatic pilots.
Subject(s)
Fetal Monitoring/methods , Labor, Obstetric/physiology , Cardiotocography/history , Cardiotocography/methods , Cardiotocography/trends , Electrocardiography , Female , Fetal Monitoring/history , Fetal Monitoring/trends , Heart Rate, Fetal , History, 20th Century , History, 21st Century , Humans , Oximetry , PregnancyABSTRACT
The aim of this article is to illustrate the history of fetal auscultation from the 19(th) century, when the fetus was considered as an object and the obstetrician as a ''mechanic of the birth'', to the present age, when the fetus is a subject and the obstetricians have at their disposal all the means they need to confirm his well-being and to early diagnose his pathologies, even using prenatal telemedicine.
Subject(s)
Cardiotocography/history , Prenatal Care/history , Stethoscopes/history , Telemedicine/history , Cardiotocography/instrumentation , Diagnostic Techniques, Obstetrical and Gynecological/history , Diagnostic Techniques, Obstetrical and Gynecological/instrumentation , Equipment Design , Female , History, 19th Century , Humans , Prenatal Care/methodsABSTRACT
Methods of assessing the fetal heart remained unchanged for approximately 150 years until the first commercial monitor suitable for clinical practice was sold in 1968. The impact and events of the last 30 to 40 years surrounding fetal heart assessment are revealed in perspectives of the past, present, and near future. Assessment practices have been shaped by the development of biotechnology, unrealistic expectations, interpretation disagreement, consumer response, and the practice and educational resources written by nursing and medicine.
