Rates and indicators of Continuous Electronic fetal monitoring - A study from Saudi Arabia

Background: This observational study aimed to describe the rates and indicators for continuous electronic fetal monitoring (EFM) during normal labour and to compare them between women who have had one pregnancy (PG) and women who have already delivered two or more children (G2 and above). Methods: The study was conducted at Mother and Child Hospital, Buraidah from July-Sept, 2013 as a descriptive cross sectional study. Results: Seventy four percent of labouring women had EFM and 25.7% had intermittent auscultation. Amongst the EFM group 62% were Primigravidas and 37.9% were multigravidas. When compared between PG and multigravidas, maconium staining (14.18vs 1.22, p value=0.001), maternal concerns for fetal heart rate (14.93 vs 6.10 p value=0.049), and syntocinon usage (14.18 vs 2.44 p value=0.005) were significantly prominent indications for Primigravidas. However trial of scar (0.00vs 15.85 p value <0.001) and associated medical problems (6.72 vs 19.51 p value 0.004) were the most frequent indications for G2 and above. For a large population of women including 13 PG and 18 Multigravidas (Overall 14.3%) there was no particular indication assigned for EFM and this was more frequent amongst Gravida2 and above (P < 0.013). Conclusion: Electronic fetal monitoring is a very common obstetric intervention. It remains a challenge to review its rates and indications in order to identify areas that needs improvement.