A recent New England Journal of Medicine issue includes the results of a study that looked at whether babies were safer during labor and delivery if their doctors not only could monitor the fetal heart rate, but also if they had fetal electrocardiogram (ECG) readings. ECG readings allow doctors to monitor the heart’s electrical activity.

The purpose of the study was to see if this additional information would give doctors useful information that might alert them of problems earlier than heart rate monitoring alone, so that they may intervene earlier and prevent possible complications.

The result: there was no statistically significant difference in outcomes as between the group of doctors that monitored only the baby’s heart rate and the group that also had ECG monitors.

You can read an article summarizing these findings here:

[Fetal ECG readings offer no advantage over heart rate monitoring during labor](http://www.nih.gov/news/health/aug2015/nichd-12a.htm)

The study looked at incidence of poor outcomes for the baby, such as death, seizures, the need for a ventilator after birth, and low Apgar scores. Additionally it looked at poor maternal outcomes, like the need for a cesarean delivery (C-section), infection, the need for a blood transfusion, and the need for assisting devices in the birth such as forceps or a vacuum.

11,000 pregnant women were involved in the study, and placed in one of the two groups. Adverse events occurred in 52 patients with doctors using both fetal heart rate and ECG monitoring, while 40 events occurred in the group with doctors who only had access to the fetal heart rate monitoring. The difference was not statistically significant.

Birth injuries, including fetal death, hypoxic ischemic encephalopathy (HIE), cerebral palsy, and brachial plexus injuries occurring as a result of shoulder dystocia are unfortunate and devastating realities for some.

Such injuries can arise in the absence of negligent care. However, sometimes health care providers fail to properly monitor the fetal heart rate, or incorrectly interpret worrisome signs. It is a positive sign that our healthcare system continues to look for ways of doing things better, including testing whether additional fetal heart monitoring might prevent more of these poor outcomes. Even if, as it appears in this instance, the additional monitoring added no benefit.