KEY POINTSl Compared with intermittent auscultation (IA), the use of continuous electronic fetal heart rate (FHR) monitoring significantly increases the rate of operative interventions [vacuum, forceps, and cesarean delivery (CD)] for nonreassuring patterns, but it does decrease the likelihood of neonatal seizures and perinatal mortality secondary to hypoxia. l With some persistent category II or III patterns, intrauterine resuscitation with maternal oxygen, change in maternal position, discontinuation of labor stimulation and/or tocolytics, or amnioinfusion (if variable decelerations) reduce the need to proceed with emergent CD but do not reduce the likelihood of asphyxial injury.
INCIDENCEThe prevalence of CD for NRFHR tracing is about 3% or more, and it is increasing (4).