• Steven L Clark, Janet A Meyers, Donna K Frye, Thomas Garthwaite, Alan J Lee, and Jonathan B Perlin.
• Hospital Corporation of America, Nashville, TN; Baylor College of Medicine, Houston, TX. Electronic address: steven.clark1@hcahealthcare.com.
• Am. J. Obstet. Gynecol. 2015 Apr 1; 212 (4): 494.e1-6.

ObjectiveThe objective of the study was to examine the clinical impact of specific fetal monitoring-related practices during induced labor.Study DesignThis was a prospective, nonrandomized study.ResultsWe studied 14,398 women undergoing oxytocin induction of labor. A decrease in the infusion rate of oxytocin in the face of specified category II fetal heart rate tracings was associated with a significantly reduced rate of neonatal intensive care unit admission (3.8% vs 5.2%, P = .01) and Apgar score less than 7 at 1 and 5 minutes (4.9% vs 6.4%, P = .01, 0.6% vs 1.1%, P = .04). Compliance with an in-use checklist was associated with both a reduction in the rate of neonatal intensive care unit admission (2.9 vs 4.4, P = .00) and a reduction in the cesarean delivery rate (15.8% vs 18.8%, P = .00).ConclusionElectronic fetal heart rate monitoring improves neonatal outcomes when unambiguous definitions of abnormal fetal heart rate and tachysystole are coupled with specific interventions. Utilization of a checklist for oxytocin monitoring is associated with improved neonatal outcomes and a reduction in the cesarean delivery rate.Copyright © 2015 Elsevier Inc. All rights reserved.

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