Interpretation of the electronic fetal heart rate during labor

Electronic fetal heart rate monitoring is commonly used to assess fetal wel l-being during labor. Although detection of fetal compromise is one benefit of fetal monitoring, there are also risks, including false-positive tests that may result in unnecessary surgical intervention. Since variable and in consistent interpretation of fetal heart rate tracings may affect managemen t, a systematic approach to interpreting the patterns is important. The fet al heart rate undergoes constant and minute adjustments in response to the fetal environment and stimuli. Fetal heart rate patterns are classified as reassuring, nonreassuring or ominous. Nonreassuring patterns such as fetal tachycardia, bradycardia and late decelerations with good short-term variab ility require intervention to rule out fetal acidosis. Ominous patterns req uire emergency intrauterine fetal resuscitation and immediate delivery. Dif ferentiating between a reassuring and nonreassuring fetal heart rate patter n is the essence of accurate interpretation, which is essential to guide ap propriate triage decisions.