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Fetal monitoring: high tech failure

Electronic fetal monitoring (EFM) the test supposed to detect cerebral palsy in the unborn child has been judged one of the great failures of high tech medicine. The test's false positive level reporting a problem where there is none is an alarming 9

This latest study, which monitored children born in California, has come to the exact same conclusion of 11 earlier trials that fetal monitoring actually puts the mother at unnecessary risk, and that simple ausculation (use of trumpet stethoscope) is just as effective.

It will be interesting to see just how long it is before EFM equipment is thrown out of the delivery room. An equally hard hitting report from 1990 seemed to put the nail in the coffin of EFM, but it has continued to play a leading role in the high tech birth.

Despite the widespread use of EFM for the past 20 years, cases of cerebral palsy have obstinately remained at a rate of two per 1,000 births. Researchers have discovered that only between 10 and 20 per cent of cases are due to labour complications.

The Californian study researched the birth records of 155,636 children in California born between 1983 and 1985 and compared those with cerebral palsy with other victims from a controlled group, all of whom had been monitored with EFM. But the researchers found that the false positive rate was 99.8 per cent, leading to "many cesarean sections (being) performed without benefit and with the potential for harm".



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