Changes in fetal monitoring practice in the UK: 1977-1984.

• Wheble AM,

  Gillmer MD,

  Spencer JA,

  Sykes GS.

Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital, Headington, Oxford.

A postal survey was undertaken between 1985 and 1987 to assess the changes that have taken place in fetal monitoring practice since 1977. Replies were received from 253 (92%) of 276 consultant obstetric units canvassed. Biophysical methods of assessing fetal well-being in the antepartum period are almost universally employed and are accepted as the best discriminators of the need to deliver the pregnancy. The number of fetal heart rate monitors on labour wards has increased by 88%. Overall, 63% of units monitor more than 60% of their patients in labour, and 87% permit suitably trained midwives to apply fetal scalp electrodes, which must now be regarded as standard practice. There is still a need for a simplified technique for fetal blood sampling. The perinatal mortality rate correlates with a prematurity factor and probably bears a greater relation to the population served than to the degree of monitoring provided.