Descriptive study of electronic fetal monitoring in a rural community: does it make a difference?

Electronic fetal monitoring (EFM) has become a standard of care in many labor and delivery settings. Studies of the effects of such monitoring have been inconclusive, although among high-risk women there have been some impressive results attributed to EFM. The present study investigated the effects of introducing EFM in a rural hospital labor and delivery setting. Using a retrospective cohort design, charts of 749 obstetrical cases admitted to the Tooele valley Hospital were reviewed and abstracted. These cases covered a four-year period: two year before EFM was installed and two years after. No significant differences (p<.05) were detected among the clinical parameters evaluate before and after monitoring became available. A difference (p<.0001) was found in the frequency of obstetrical consultations obtained. Before EFM was available 11% of patients had consults compared with 3% after. However, during the period when EFM was available there were as many consults obtained on unmonitored patients (2.9%) as for monitored women (2.3%). Neither Cesarean section rate nor mean Apgar scores changed between the two periods. It would appear the EFM is of limited usefulness in a low-risk, primary care setting.