Electronic Fetal Monitoring: Past, Present and Future

Abstract

Electronic fetal monitoring was introduced in 1957 and has been used clinically to assess fetal well-being and uterine contractions throughout pregnancy. The electronic fetal monitoring can detect fetal distress early during labor and has significantly contributed to reduce fetal morbidity and mortality. Currently, electric fetal monitoring has been accepted worldwide, at every delivery unit and outpatient clinic in most medical centers. Although electronic fetal monitoring using Doppler ultrasound and tocodynamometry has many advantages such as non-invasiveness and simplicity, the accuracy of measurement varies according to maternal movement and band-holding devices give discomfort to women during the examination. Recently, devices for intrauterine pressure measurement are seldom used because of the risks of uterine rupture, infection, and placental abruption in spite of its high accuracy. Nowadays, wireless fetal monitoring has been developed and commercially available to compensate these limitations. Electrohysterography and fetal electrocardiogram consist of the wireless fetal monitoring device. The device is handy and helpful in the management of high-risk pregnancy by enabling fetal monitoring outside the hospital, even at home. It is expected that the birth environment may become safer through the development of a monitoring system based on artificial intelligence by improving the predictability of complicated high-risk pregnancies. This review summarizes the past and present of electronic fetal monitoring and suggests future directions of fetal monitoring.