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Journal of Pregnancy
Volume 2017 (2017), Article ID 8529816, 5 pages
Research Article

Monitoring Fetal Heart Rate during Labor: A Comparison of Three Methods

1Department of Anesthesiology, University of Florida College of Medicine, Gainesville, FL, USA
2Department of Obstetrics and Gynecology, University of Florida College of Medicine, Gainesville, FL, USA
3OBMedical, Jonesville, FL, USA
4Winnie Palmer Hospital for Women & Babies, Orlando, FL, USA

Correspondence should be addressed to Tammy Y. Euliano

Received 27 July 2016; Revised 8 February 2017; Accepted 12 February 2017; Published 14 March 2017

Academic Editor: Fabio Facchinetti

Copyright © 2017 Tammy Y. Euliano et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The purpose of the study was to compare the accuracy of a noninvasive fetal heart rate monitor with that of ultrasound, using a fetal scalp electrode as the gold standard, in laboring women of varying body habitus, throughout labor and delivery. Laboring women requiring fetal scalp electrode were monitored simultaneously with the investigational device (noninvasive fetal ECG), ultrasound, and fetal scalp electrode. An algorithm extracted the fetal heart rate from the noninvasive fetal ECG signal. Each noninvasive device recording was compared with fetal scalp electrode with regard to reliability by positive percent agreement and accuracy by root mean squared error. Seventy-one women were included in this analysis. Positive percent agreement was % for noninvasive fetal ECG and % for ultrasound. The root mean squared error compared with fetal scalp electrode-derived fetal heart rate was 4.8 ± 2.0 bpm for noninvasive fetal ECG and 14.3 ± 8.2 bpm for ultrasound. The superiority of noninvasive fetal ECG was maintained for stages 1 and 2 of labor and increases in body mass index. Compared with fetal scalp electrode-derived fetal heart rate, noninvasive fetal ECG is more accurate and reliable than ultrasound for intrapartum monitoring for stages 1 and 2 of labor and is less affected by increasing maternal body mass index. This confirms the results of other workers in this field.