The false alarm problem
Almost every worrying tracing is a false alarm.
In a study of 155,636 births, babies with multiple late decelerations or reduced variability on the monitor had about 2.7 times the odds of cerebral palsy. Of all the babies who showed those patterns, 0.19% went on to have cerebral palsy. Put the other way, 99.8% of the worrying tracings were false alarms.
99.8%
Of worrying monitor patterns that were false alarms for cerebral palsy
155,636 births
Most tracings are also classified as Category II, an indeterminate middle group defined only by what it is not. Expert consensus states that Category II patterns occur in the majority of babies in labor and that there is no standard national approach to managing them.
Question to ask in labor"Which category is the tracing in, what specifically concerns you about it, and what will we try before we go to the operating room?"
Where this comes from:
180. Nelson KB, Dambrosia JM, Ting TY, Grether JK. Uncertain value of electronic fetal monitoring in predicting cerebral palsy. N Engl J Med. 1996;334(10):613-618.
181. Clark SL, Nageotte MP, Garite TJ, et al. Intrapartum management of category II fetal heart rate tracings: towards standardization of care. Am J Obstet Gynecol. 2013;209(2):89-97.
Covered in the essential classes
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This page is educational. It supports the conversation with your own clinicians. It is not consent to any treatment, and it cannot assess you. If you are worried about a symptom now, see urgent warning signs.