Clinicians use the EFM as a proxy to assess fetal oxygenation status, fetal well-being, and potential compromise. Despite the widespread use of this technology, neonatal hypoxia and acidosis continue to make up a high proportion of neonatal morbidity at term. Consequently, the high false-positive rate of EFM for predicting adverse neonatal effects has led to an increase in the quality of operative vaginal and cesarean delivery, with elevated rates of associated maternal and neonatal morbidity. This fact invariably leads to a paradox we have subsequently defined as the “obstetrical paradox.” Herein, we explore the potential solutions to this paradox and introduce a novel noninvasive technique to assess fetal acid-base status in utero known as the “FETAL technique”. The FETAL procedure, currently under investigation, applies the discrete Fourier transformation to EFM tracings to determine the fetal heart rate’s spectral frequency distribution. These specific frequency distributions correlate with specific umbilical pH values and may provide the missing link between fetal heart rate patterns and acid-base status at birth. As we work toward realizing the full potential benefits of EFM, finding the best assessment strategies to evaluate fetal pH in real-time remains a crucial goal in obstetrics.

Reference: https://www.hindawi.com/journals/jp/2020/7801039/