Intrapartum fetal surveillance

Rohan D’Souza, Sabaratnam Arulkumaran

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

1 Citation (Scopus)

Abstract

With the onset of labour, the fetus embarks upon a most perilous journey – a journey fraught with risks of asphyxia, trauma, intervention and even death. Yet, this journey must be made, as the odds today still favour a vaginal birth. Although it is unlikely that scientific advances will be able to make this journey any easier, there certainly have been attempts at making this journey safer for both mother and baby. To this end, the concept of ‘intrapartum fetal surveillance’ was introduced decades ago. What began with the listening to the fetal heart beat using a Pinard stethoscope has now become a sophisticated discipline, incorporating the ever-increasing knowledge of the science of obstetrics and the latest technology. The aim of fetal surveillance during labour is to identify the fetus at risk of an adverse outcome based on our ability to understand how the fetus reacts to stress before it becomes compromised. Sadly, no single method is foolproof, and even in the developed world, intrapartum asphyxia with resultant mortality or severe morbidity continues to be a cause for concern. The most recent Perinatal Mortality report for England and Wales [1] reveals that 256 stillbirths and 165 neonatal deaths in the year 2006 were a direct result of intrapartum causes. The fear of litigation remains the obstetrician's worst nightmare, and ensuring a good outcome with minimum intervention his greatest challenge. When electronic fetal monitoring (EFM) was introduced in the 1960s, a drastic reduction in perinatal morbidity and mortality was anticipated.

Original languageEnglish
Title of host publicationBest Practice in Labour and Delivery
PublisherCambridge University Press
Pages38-53
Number of pages16
ISBN (Electronic)9780511635489
ISBN (Print)9780521720687
DOIs
Publication statusPublished - 1 Jan 2009

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