Perinatal outcomes were not improved nor were operative-delivery rates decreased when fetal electrocardiographic (ECG) ST-segment analysis was used as an adjunct to conventional intrapartum electronic fetal heart rate monitoring in a study of 11,108 patients. The open group consisted of 5,532 women and the masked group had 5,576 participants. Researchers determined:

• Primary outcomes occurred in 0.9% of fetuses or neonates of women in the open group and 40 in 0.7% of fetuses in the masked group.

• Among individual components of the primary outcome, only the frequency of a 5-minute Apgar score of 3 or less differed significantly between neonates of women in the open group and those in the masked group (0.3% vs. 0.1%).

• There were no significant between-group differences in the rate of cesarean delivery (16.9% vs. 16.2%).

Citation: Belfort MA, Saade GR, Thom E, et al. A randomized trial of intrapartum fetal ECG ST-segment analysis. N Engl J Med 2015; 373:632-641. doi: 10.1056/NEJMoa1500600.