Assessment of the fetus: intermittent auscultation, electronic fetal heart rate tracing, and fetal pulse oximetry

Intrapartum assessment of fetal well-being has evolved over the last 40 years, with the primary focus being fetal heart rate assessments. Despite widespread use and initial enthusiasm for the potential for heart rate monitoring to reduce fetal and neonatal mortality and morbidity, conclusive evidence of improvement in long-term outcomes is lacking. Its use is associated with an increase in operative obstetric interventions and may increase morbidity associated with such interventions. Current investigation includes fetal pulse oximetry and further analysis of specific fetal electrocardiographic changes associated with hypoxic stress. Currently it is likely that fetal heart rate monitoring will maintain its role as a common intervention in obstetric units.