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Abstract
Labour is a physiological stress to the fetus during the transition from the intrauterine to the extrauterine environment. The commonest stress results from the intermittent interruption to the maternal-fetal oxygen transfer.
Rreview
A high risk pregnancy is one in which some conditions puts the mother, the developing fetus, or both at higher –than-normal risk for complications during or after the pregnancy and birth.
Fetal monitoring is defined as watching the baby’s heart rate for indicators of stress, usually during labour and birth, it include intermittent stethoscopic auscultation ( Pinard and Doppler device ), continuous electronic fetal monitoring, fetal scalp blood sampling, scalp stimulation, vibroacoustic stimulation, fetal pulse oximetry, fetal electrocardiography, near-infrared spectroscopy and intrapartum Doppler velocimetery.
Summary and conclusion
In high-risk pregnancies there is little sound scientific evidence to support the choice of EFM over intermittent auscultation (at least once every 15 minutes in the first stage of labour and at least once every 5 minute in the second stage ). This does not mean that EFM may not be beneficial in high-risk pregnancies; high risk categories includes, low gestational age, high maternal age, placental or cord problems, meconium in the amniotic fluid, hypertension, proteinuria, malpresentation, poor outcome in previous pregnancies and medical complication.