Medical Researchers Want Accuracy in Fetal Heart Rate Monitoring

In what seems to be one of the biggest and perhaps most demanding studies to this date, Washington University School of Medicine scientists are trying to better understand the use of the most widespread obstetric procedure used by many physicians — fetal heart rate monitoring.

Fetal heart rate monitoring was first introduced in back the early ‘70s to continuously check unborn child’s heart rates and, needless to say, on time intervene, if found necessary. The main aim was to reduce the risk of death as well as cerebral palsy resulting from insufficient oxygen to the baby’s sensitive brain.

In spite of the simple procedure being used in over 85% of United States childbirths, the stillbirth rate hasn’t changed and the rate of cerebral palsy has unfortunately increased.

“The technology became accepted practice before we knew if it worked or not.” These are the words of Dr. Alison Cahill, Assistant Professor in the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine at Washington.

In order to compare the fetal heart rate patterns to neonatal outcomes in seven thousands deliveries Dr. Alison Cahill and her colleague medical scientists have received a $3.5 million, 5-year grant from the National Institute of Child Health and Human Development.

Dr. Alison Cahill also said that: “Physicians are intervening on EFM recordings they think have particular meaning, but the recordings are not accurately predicting which babies will have neurological damage.” She also added that: “If we can learn more about these recordings and what they mean, we can possibly reduce the number of c-sections and also improve newborn care.”

For many years, the heart rate patterns were divided into 2 main categories: non-reassuring and reassuring. New recommendations introduced in 2008 divided the heart rate patterns into 3 main categories considered abnormal, normal, and intermediate. Intermediate readings are the most common, Dr. Alison Cahill said, on the other hand, “we have no information about the meanings of those patterns.”

Medical researches hope the study will ultimately result in much more precise interpretations of the recordings and help lessen the rate of C-sections as well, which have risen to 32% of all childbirths from 7% when fetal heart rate monitoring was first introduced.

Due to the threat of liability, a lot of children who might have been okay after a natural childbirth are being delivered with forceps or surgically, are the words of the Dr. George Macones, Mitchell and Elaine Yanow Professor and Chair, Department of Obstetrics and Gynecology.

Sophisticated fetal heart rate monitoring technology holds promise, were the words of the Dr. Alison Cahill said that. She also said that: “It is hard to imagine second-to-second monitoring is less valuable. We just have not looked at it in a successful way.”

In the study to come, medical scientists will assess the fetal heart rate monitoring recordings a hundred and twenty minutes before childbirth and see whether those recordings predict which babies will suffer neurological damage. What’s more, two hundred full-term children born at Barnes-Jewish Hospital will undergo much more thorough tests in order to detect brain damage, like an MRI or cord blood sample.