Electronic monitoring of the fetal heartbeat during delivery is not helpful in preventing cerebral palsy and may lead to a higher rate of potentially dangerous Caesarean sections, a large study has found.
In a study of 156,000 live births in California, researchers at the National Institute of Neurological Disorders and Strokes and several medical schools tracked which cases of fetal monitoring led to C-sections and which babies developed cerebral palsy, a disability that results from damage to the brain's motor centers and causes serious movement and speech problems.It has been standard medical practice to perform C-sections whenever certain abnormal heartbeats are detected. But while some of these abnormalities are associated with cerebral palsy, the researchers found that doing a C-section has no preventive impact: Children delivered by Caesarean section did not have a lower frequency of cerebral palsy than those delivered normally.
The researchers also found that in the vast majority of babies, abnormal heartbeats did not indicate cerebral palsy: 99.8 percent of babies in whom such heartbeats were detected, and who were delivered by C-section, did not develop cerebral palsy.
Both findings reinforce other research showing that most cerebral palsy cases can be traced to damage to the fetuses' central nervous system early in pregnancy.
Since 12 percent of C-sections have complications for the mother, ranging from internal bleeding to post-operative problems, the researchers conclude that electronic monitoring may be more risky than beneficial in most cases.
"Continuous electronic fetal monitoring promised much but has achieved little," concluded Dr. Dermot MacDonald in an editorial accompanying the report in the New England Journal of Medicine.
- Alison Bass