Selective versus routine intrapartum monitoring: comparison of effects on perinatal outcome.

This study compares perinatal results of 7,604 deliveries in two successive years (1976--1977) in which no policy changes occurred other than a four-fold increase in electronic intrapartum monitoring. In the first year 15.4 per cent of births were monitored selectively. In the second year all births were monitored, with the exception of patients admitted at an advanced stage of labor and elective cesarean section. The results show no significant improvement either in intrapartum or in early neonatal mortality rates. The same results obtained in cesarean section rate and in instrumental deliveries. The only positive result is a significant reduction of low Apgar scores in the unselected monitoring group (1977). The low morbidity is considered to be a result not only of increased monitoring, but also of active management of labor, of a short duration of labor and of intensive neonatal care.