Continuous Electronic Fetal Monitoring during Labor: A Critique and a Reply to Contemporary Proponents

Thomas P. Sartwelle; James C. Johnston

doi:10.1055/s-0038-1632404

The Surgery Journal, Inhaltsverzeichnis

CC-BY 4.0 · Surg J (N Y) 2018; 04(01): e23-e28
DOI: 10.1055/s-0038-1632404

Review Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Continuous Electronic Fetal Monitoring during Labor: A Critique and a Reply to Contemporary Proponents

Thomas P. Sartwelle

¹Deans and Lyons, LLP, Houston, Texas

,

James C. Johnston

²Global Neurology Consultants, USA and Auckland, New Zealand

› Institutsangaben

Abstract

A half century after continuous electronic fetal monitoring (EFM) became the omnipresent standard of care for the vast majority of labors in the developed countries, and the cornerstone for cerebral palsy litigation, EFM advocates still do not have any scientific evidence justifying EFM use in most labors or courtrooms. Yet, these EFM proponents continue rationalizing the procedure with a rhetorical fog of meaningless words, misleading statistics, archaic concepts, and a complete disregard for medical ethics. This article illustrates the current state of affairs by providing an evidence-based review penetrating the rhetorical fog of a prototypical EFM advocate.

Keywords

electronic fetal monitoring - cerebral palsy - medical ethics - journal of child neurology - Dr. Max Wiznitzer - Dr. Marc Patterson

Volltext

Referenzen

References
1 Nelson KB, Sartwelle TP, Rouse DJ. Electronic fetal monitoring, cerebral palsy, and caesarean section: assumptions versus evidence. BMJ 2016; 355: i6405
2 Alfirevic Z, Devane D, Gyte GML, Cuthbert A. Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour. Cochrane Database Syst Rev 2017; 2 (02) CD006066
3 MacLennan A, Hankins G, Speer N. Only an expert witness can prevent cerebral palsy. Obstet Gynecol 2006; 8 (01) 28-30
4 Costantine MM, Saade GR. The first cesarean: role of “fetal distress” diagnosis. Semin Perinatol 2012; 36 (05) 379-383
5 Clark SL, Hankins GD. Temporal and demographic trends in cerebral palsy--fact and fiction. Am J Obstet Gynecol 2003; 188 (03) 628-633
6 Donn SM, Chiswick ML, Fanaroff JM. Medico-legal implications of hypoxic-ischemic birth injury. Semin Fetal Neonatal Med 2014; 19 (05) 317-321
7 Badawi N, Keogh JM. Causal pathways in cerebral palsy. J Paediatr Child Health 2013; 49 (01) 5-8
8 Wiznitzer M. Electronic fetal monitoring: are we asking the correct questions?. J Child Neuro 2016; 32 (03) 344-345
9 Sartwelle TP, Johnston JC. Cerebral palsy litigation: change course or abandon ship. J Child Neurol 2015; 30 (07) 828-841
10 MacLennan AH, Thompson SC, Gecz J. Cerebral palsy: causes, pathways, and the role of genetic variants. Am J Obstet Gynecol 2015; 213 (06) 779-788
11 Sartwelle TP, Johnston JC, Arda B. Electronic fetal monitoring, cerebral palsy litigation, and bioethics: the evils in Pandora's box. J. Pediatric Care. 2016; 2: 2
12 MacLennan A, Nelson KB, Hankins G, Speer M. Who will deliver our grandchildren? Implications of cerebral palsy litigation. JAMA 2005; 294 (13) 1688-1690
13 Holt v. Secretary of the Department of Health and Human Services, No. 05–0136V, U.S. Court of Federal Claims, Office of Special Master. June 24, 2015
14 Asad v. Continental Airlines Inc., 314 F. Supp. 2d 726 (N.D. Ohio 2004)
15 Johnston JC, Sartwelle TP. The expert witness in medical malpractice litigation: through the looking glass. J Child Neurol 2013; 28 (04) 484-501
16 O'Callaghan M, MacLennan A. Cesarean delivery and cerebral palsy: a systematic review and meta-analysis. Obstet Gynecol 2013; 122 (06) 1169-1175
17 Report of the American College of Obstetricians and Gynecologists' Task Force on Neonatal Encephalopathy. Executive Summary: Neonatal Encephalopathy and Neurologic Outcome. 2nd ed. Report of the American College of Obstetricians and Gynecologists' Task Force on Neonatal Encephalopathy. Obstet Gynecol 2014; 123 (04) 896-901
18 Sartwelle TP, Johnston JC, Arda B. Perpetuating myths, fables, and fairy tales: a half century of electronic fetal monitoring. Surg J (N Y) 2015; 1 (01) e28-e34
19 Sartwelle TP, Johnston JC, Arda B. Electronic fetal monitoring, cerebral palsy, and medical ethics: nonsense of a high order. Med Law Internat'l. 2017; 17 (1–2): 43-64
20 Vreeman RC, Carroll AE. Festive medical myths. BMJ 2008; 337: a2769
21 Prasad V, Cifu A, Ioannidis JP. Reversals of established medical practices: evidence to abandon ship. JAMA 2012; 307 (01) 37-38
22 Prasad V, Gall V, Cifu A. The frequency of medical reversal. Arch Intern Med 2011; 171 (18) 1675-1676
23 Gartler SM. The chromosome number in humans: a brief history. Nat Rev Genet 2006; 7 (08) 655-660
24 Graham EM, Petersen SM, Christo DK, Fox HE. Intrapartum electronic fetal heart rate monitoring and the prevention of perinatal brain injury. Obstet Gynecol 2006; 108 (3 Pt 1): 656-666
25 Banta DH, Thacker SB. Historical controversy in health technology assessment: the case of electronic fetal monitoring. Obstet Gynecol Surv 2001; 56 (11) 707-719
26 Quilligan EJ, Paul RH. Fetal monitoring: is it worth it?. Obstet Gynecol 1975; 45 (01) 96-100
27 Benson RC, Shubeck F, Deutschberger J, Weiss W, Berendes H. Fetal heart rate as a predictor of fetal distress. A report from the collaborative project. Obstet Gynecol 1968; 32 (02) 259-266
28 Sartwelle TP. Electronic fetal monitoring: a bridge too far. J Leg Med 2012; 33 (03) 313-379
29 Molina G, Weiser TG, Lipsitz SR. , et al. Relationship between cesarean delivery rate and maternal and neonatal mortality. JAMA 2015; 314 (21) 2263-2270
30 Clark SL, Nageotte MP, Garite TJ. , et al. Intrapartum management of category II fetal heart rate tracings: towards standardization of care. Am J Obstet Gynecol 2013; 209 (02) 89-97
31 Ellenberg JH, Nelson KB. The association of cerebral palsy with birth asphyxia: a definitional quagmire. Dev Med Child Neurol 2013; 55 (03) 210-216
32 Nelson KB, Ellenberg JH. Antecedents of cerebral palsy. Multivariate analysis of risk. N Engl J Med 1986; 315 (02) 81-86
33 Fahey MC, Maclennan AH, Kretzschmar D, Gecz J, Kruer MC. The genetic basis of cerebral palsy. Dev Med Child Neurol 2017; 59 (05) 462-469
34 Clark SL, Hamilton EF, Garite TJ, Timmins A, Warrick PA, Smith S. The limits of electronic fetal heart rate monitoring in the prevention of neonatal metabolic acidemia. Am J Obstet Gynecol 2017; 216 (02) 163.e1-163.e6
35 Yang M, Stout MJ, López JD, Colvin R, Macones GA, Cahill AG. Association of fetal heart rate baseline changes and neonatal outcomes. Am J Perinatol 2017; 34 (09) 879-886
36 INFANT Collaborative Group. Computerised interpretation of fetal heart rate during labour (INFANT): a randomised controlled trial. Lancet 2017; 389 (10080): 1719-1729
37 Belfort MA, Saade GR, Thom E. , et al; Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal–Fetal Medicine Units Network. A randomized trial of intrapartum fetal ECG ST-segment analysis. N Engl J Med 2015; 373 (07) 632-641
38 Cahill AG, Roehl KA, Odibo AO, Macones GA. Association and prediction of neonatal acidemia. Am J Obstet Gynecol 2012; 207 (03) 206.e1-206.e8
39 Safe Motherhood and Newborn Health Committee. FIGO consensus guidelines on intrapartum fetal monitoring. 2015. http://www.jsog.or.jp/international/pdf/CTG.pdf . Accessed February 8, 2018
40 Carson GD. Don't just do something, stand there. J Obstet Gynaecol Can 2016; 38 (09) 791-792
41 Lear CA, Galinsky R, Wassink G. , et al. The myths and physiology surrounding intrapartum decelerations: the critical role of the peripheral chemoreflex. J Physiol 2016; 594 (17) 4711-4725
42 Clark SL, Meyers JA, Frye DK, Garthwaite T, Lee AJ, Perlin JB. Recognition and response to electronic fetal heart rate patterns: impact on newborn outcomes and primary cesarean delivery rate in women undergoing induction of labor. Am J Obstet Gynecol 2015; 212 (04) 494.e1-494.e6
43 National Institute for Health and Care Excellence. Intrapartum care for health women and babies. 2017. https://www.nice.org.uk/guidance/cg190/chapter/Recommendations#monitoring-during-labour . Accessed February 8, 2018
44 ACOG Committee on Obstetric Practice. Approaches to limit intervention during labor and birth. Number 687. February 2017. https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Approaches-to-Limit-Intervention-During-Labor-and-Birth . Accessed February 8, 2018