Electronic fetal monitoring (EFM) is the most commonly-used screening test in developed countries, applied to almost all deliveries in a hospital setting. 1 Although EFM aims to be a noninvasive tool to reduce adverse outcomes by identifying fetuses that are developing acidemia, its value has not been fully established. 2 The challenges of interpreting EFM patterns have been extensively discussed in the literature, with an ongoing debate on which EFM patterns are most predictive of acidemia. [2][3][4] In the hope of improving the yield of EFM patterns for the prediction of neonatal outcomes, a 2008 consensus focused on

The spectrum of disease in congenital cytomegalovirus (cCMV) is broad and true phenotype of this congenital infection is likely obscured by the predominance of children born with no overt signs of this congenital infection. In this study extracted records directly from our EMR to elucidate the progression of developmental disorders patients with cCMV. STUDY DESIGN: SlicerDicer TM , a reporting tool in our EpicÒ EMR, was used to identify patients seen in our cCMV Clinic at Texas Children's Hospital in Houston, Texas, with a diagnosis of congenital cytomegalovirus (cCMV) infection between 2008 and 2018. ICD-10 diagnoses and encounters were extracted with a series of SQL queries. Using SAS V9.4 (Cary, N.C.) categorized ICD-10 codes by semantic terms associated with developmental disabilities guided by SNOMED-CTÒ. RESULTS: Data acquisition took less than a minute to complete and included 55,558 unique encounters, 48,582 billing diagnoses. Of 112 patients with cCMV seen in our clinic, 76 (68%) had symptomatic cCMV (ScCMV) and 36 (32%) were classified as having asymptomatic cCMV (AcCMV). 60 (79%) of children with ScCMV had at least one disorder of development noted in their medical record compared with 20 (56%) of the AcCMV. For the children with AcCMV, we found that there were 1,110 physical therapy, 443 occupational therapy, 390 speech therapy, 189 audiology, and 82 neurology, provider encounters over this 10-year span. CONCLUSION: Despite the "asymptomatic" designation, many children with AcCMV children go on to develop disorders of development later in life. This finding emphasizes the need for continued surveillance of these children throughout childhood and highlights the importance of education regarding this common congenital viral infection. Furthermore, the EMR gives us the potential to study the many facets of this disease in finer detail and identify rates of disease progression throughout time. These results should prove invaluable for anticipatory guidance and in generating cost-models for the true economic impact of cCMV.