In April 2008, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the American College of Obstetricians and Gynecologists, and the Society for Maternal-Fetal Medicine partnered to sponsor a 2-day workshop to revisit nomenclature, interpretation, and research recommendations for intrapartum electronic fetal heart rate monitoring. Participants included obstetric experts and representatives from relevant stakeholder groups and organizations. This article provides a summary of the discussions at the workshop. This includes a discussion of terminology and nomenclature for the description of fetal heart tracings and uterine contractions for use in clinical practice and research. A three-tier system for fetal heart rate tracing interpretation is also described. Lastly, prioritized topics for future research are provided.
Electronic fetal heart rate monitoring: research guidelines for interpretation. National Institute of Child Health and Human Development Research Planning Workshop
ACOG Practice Bulletin. Clinical Management Guidelines for Obstetrician-Gynecologists, Number 70, December 2005 (Replaces Practice Bulletin Number 62, May 2005). Intrapartum fetal heart rate monitoring
Decreased respiratory rate variability during mechanical ventilation is associated with increased mortality
The clinical interpretation and significance of electronic fetal heart rate patterns 2 h before delivery: an institutional observational study
Vaginal birth after cesarean for cephalopelvic disproportion: effect of birth weight difference on success
Human factors and error in perinatal care: the interplay between nurses, machines, and the work environment
The impact of non-significant variable decelerations appearing in the latent phase on delivery mode: a prospective cohort study
A collaborative interdisciplinary approach to electronic fetal monitoring: report of a statewide initiative
Immediate newborn outcome and mode of delivery: use of standardized fetal heart rate pattern management
The effect of cigarette smoking during pregnancy on mode of delivery in uncomplicated term singleton pregnancies
Association between intrapartum fetal heart rate patterns and neonatal abstinence syndrome in methadone exposed neonates
Comparison of five classification systems for interpreting electronic fetal monitoring in predicting neonatal status at birth
Pre-induction cervical ripening: comparing between two vaginal preparations of dinoprostone in women with an unfavorable cervix
Mechanism of reduction of newborn metabolic acidemia following application of a rule-based 5-category color-coded fetal heart rate management framework
Observation on validity of the five-tier system for fetal heart rate pattern interpretation proposed by Japan Society of Obstetricians and Gynecologists
Maternal and umbilical cord ischemia-modified albumin levels in nonreassuring fetal heart rate tracings regarding the mode of delivery
Documentation improvements following multidisciplinary educational program on electronic fetal heart rate tracings
Comparison of delayed versus immediate pushing during second stage of labor for nulliparous women with epidural anesthesia
The recognition and management of intrapartum fetal heart rate emergencies: beyond definitions and classification
Scattering transform for intrapartum fetal heart rate variability fractal analysis: a case-control study
Risks of parenteral antihypertensive therapy for the treatment of severe maternal hypertension are low
Race, Insurance Status, and Nulliparous, Term, Singleton, Vertex Cesarean Indication: A Case Study of a New England Tertiary Hospital
Short-term neonatal outcome in diabetic versus non-diabetic pregnancies complicated by non-reassuring foetal heart rate tracings
Nonstress testing at ≤ 32.0 weeks' gestation: a randomized trial comparing different assessment criteria
Impediments to a unified international approach to the interpretation and management of intrapartum cardiotocographs
Training residents to be factually accurate and articulate: A case study using foetal heart rate monitoring nomenclature
The Regional Centralization of Electronic Fetal Heart Rate Monitoring and Its Impact on Neonatal Acidemia and the Cesarean Birth Rate
Fetal heart rate monitoring category 3 during the 2nd stage of labor is an independent predictor of fetal acidosis
Elevated C-reactive protein levels in histological chorioamnionitis at term: impact of funisitis on term neonates
Predictors for prolonged interval from premature rupture of membranes to spontaneous onset of labor at term
Neonatal complications in vacuum-assisted vaginal delivery: are they associated with number of pulls, cup detachments, and duration of vacuum application?
Transient accelerations of fetal heart rate analyzed by computerized cardiotocography in the third trimester of pregnancy
Agreement of three interpretation systems of intrapartum foetal heart rate monitoring by different levels of physicians
Graded classification of fetal heart rate tracings: association with neonatal metabolic acidosis and neurologic morbidity
Intermittent auscultation of the fetal heart rate during labor: an opportunity for shared decision making
Reliability in cardiotocography interpretation - impact of extended on-site education in addition to web-based learning: an observational study
Dural Puncture Epidural Technique Improves Labor Analgesia Quality With Fewer Side Effects Compared With Epidural and Combined Spinal Epidural Techniques: A Randomized Clinical Trial
Vaginal Dinoprostone Versus Intravenous Oxytocin for Labor Induction in Patients Not Responsive to a First Dose of Dinoprostone: A Randomized Prospective Study
Fetal response to intramuscular epinephrine for anaphylaxis during maternal penicillin desensitization for secondary syphilis
Temporal and quantitative associations of electronic fetal heart rate monitoring patterns and neonatal outcomes†
Does the International Classification of Disease (ICD-9) code accurately identify neonates who clinically have hypoxic-ischemic encephalopathy?
Intrapartum factors associated with neonatal hypoxic ischemic encephalopathy: a case-controlled study
Oligohydramnios is an independent risk factor for perinatal morbidity among women with pre-eclampsia who delivered preterm
The value of daily fetal heart rate home monitoring in addition to serial ultrasound examinations in pregnancies complicated by fetal gastroschisis
The fetal heart rate collaborative practice project: situational awareness in electronic fetal monitoring-a Kaiser Permanente Perinatal Patient Safety Program Initiative
Antenatal interventions based upon fetal surveillance of the daily opioid exposed fetus: A descriptive analysis
Fractal Analysis and Hurst Parameter for Intrapartum Fetal Heart Rate Variability Analysis: A Versatile Alternative to Frequency Bands and LF/HF Ratio
Choice of scheduled cesarean delivery versus trial of labor for advanced maternal age primiparous women
Labor Onset, Oxytocin Use, and Epidural Anesthesia for Vaginal Birth after Cesarean Section and Associated Effects on Maternal and Neonatal Outcomes in a Tertiary Hospital in China: A Retrospective Study
Electronic fetal monitoring characteristics of a patient with sudden onset of placental abruption and intrauterine fetal demise: A case report
Perinatal outcome in women with prolonged premature rupture of membranes at term undergoing labor induction
Fetal heart rate classification proposed by the perinatology committee of the Japan Society of Obstetrics and Gynecology: reproducibility and clinical usefulness
The 2008 National Institute of Child Health and Human Development report on fetal heart rate monitoring
Are we (mis)guided by current guidelines on intrapartum fetal heart rate monitoring? Case for a more physiological approach to interpretation
Use of artificial intelligence (AI) in the interpretation of intrapartum fetal heart rate (FHR) tracings: a systematic review and meta-analysis
Marked variability in intrapartum electronic fetal heart rate patterns: association with neonatal morbidity and abnormal arterial cord gas
Clinical factors associated with congenital cytomegalovirus infection: A cohort study of pregnant women and newborns
Evaluation of 3-tier and 5-tier FHR pattern classifications using umbilical blood pH and base excess at delivery
The 2008 National Institute of Child Health and Human Development workshop report on electronic fetal monitoring: update on definitions, interpretation, and research guidelines
Impact of Maternal Country of Birth on Type-1-Diabetes Therapy and Outcome in 27,643 Children and Adolescents from the DPV Registry
Risk factors for Cesarean delivery in pregnancies with a small-for-gestational-age fetus undergoing induction of labor
Added prognostic value of longitudinal changes of angiogenic factors in early-onset severe pre-eclampsia: a prospective cohort study.
Assessment of the angle of progression and distance perineum-head in the prediction of type of delivery and duration of labor using intrapartum ultrasonography
The effect of combined spinal epidural versus epidural analgesia on fetal heart rate in laboring patients at risk for uteroplacental insufficiency
Impact of tocolysis-intent magnesium sulfate and beta-adrenergic agonists on perinatal brain damage in infants born between 28-36 weeks' gestation
Soluble fms-like tyrosine kinase to placental growth factor ratio in different stages of early-onset fetal growth restriction and small for gestational age
New FIGO and Swedish intrapartum cardiotocography classification systems incorporated in the fetal ECG ST analysis (STAN) interpretation algorithm: agreements and discrepancies in cardiotocography classification and evaluation of significant ST events
Risk factors for nonreassuring fetal heart rate tracings after artificial rupture of membranes in spontaneous labor
A Comprehensive Evaluation of the Predictive Abilities of Fetal Electrocardiogram-Derived Parameters during Labor in Newborn Acidemia: Our Institutional Experience
Oxytocin levels in low-risk primiparas following breast stimulation for spontaneous onset of labor: a quasi-experimental study
Vacuum extraction in twin deliveries-maternal and neonatal consequences: a retrospective cohort study
Surfactant reduced the mortality of neonates with birth weight ⩾1500 g and hypoxemic respiratory failure: a survey from an emerging NICU network
Can the Myocardial Performance Index Be Used as a New Predictive Factor for a Poor Prognosis in Fetuses With Idiopathic Polyhydramnios?
Evaluation of cord blood creatine kinase (CK), cardiac troponin T (cTnT), N-terminal-pro-B-type natriuretic peptide (NT-proBNP), and s100B levels in nonreassuring foetal heart rate.
Fetal heart rate pattern interpretation in the second stage of labor using the five-tier classification: impact of the degree and duration on severe fetal acidosis
Fetal heart rate patterns related to neonatal brain damage and neonatal death in placental abruption
Phase-rectified signal averaging for intrapartum electronic fetal heart rate monitoring is related to acidaemia at birth
Prophylactic intravenous ephedrine to minimize fetal bradycardia after combined spinal-epidural labour analgesia: a randomized controlled study
True knot at the time of delivery: electronic fetal monitoring characteristics and neonatal outcomes
Fetal Sinus Bradycardia Is Associated with Congenital Hypothyroidism: An Infant with Ectopic Thyroid Tissue
Clinical Experiences of Intravenous Hydralazine and Labetalol for Acute Treatment of Severe Hypertension in Pregnant Thai Women
ST waveform analysis versus cardiotocography alone for intrapartum fetal monitoring: a systematic review and meta-analysis of randomized trials
Intrapartum fetal heart rate patterns preceding terminal bradycardia in infants (>34 weeks) with poor neurological outcome: A regional population-based study in Japan
Association between exposure to air pollution during pregnancy and false positives in fetal heart rate monitoring
RETRACTED ARTICLE: Intrapartum cardiotocogram monitoring between obstetricians and computer analysis
Decision-to-delivery interval in pregnant women with intrapartum non-reassuring fetal heart rate patterns
Effect of Oxygen vs Room Air on Intrauterine Fetal Resuscitation: A Randomized Noninferiority Clinical Trial
Intrapartum zigzag pattern of fetal heart rate is an early sign of fetal hypoxia: A large obstetric retrospective cohort study.
Individual risk assessment for prenatal counseling in early-onset growth-restricted and small-for-gestational-age fetuses
Maternal Oxygen Supplementation Compared With Room Air for Intrauterine Resuscitation: A Systematic Review and Meta-analysis
Intrapartum fetal heart rate patterns and perinatal outcome in chorioamnionitis at or beyond 34 weeks of gestation.
Amniotic fluid embolism - implementation of international diagnosis criteria and subsequent pregnancy recurrence risk.
Concordance analysis of intrapartum cardiotocography between physicians and artificial intelligence-based technique using modified one-dimensional fully convolutional networks.
Use of sound-elicited fetal heart rate accelerations to assess fetal hearing in the second and third trimester
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