Please note: In 2003, the CTF updated its Grades of Recommendations to include an "I Recommendation" for situations where insufficient evidence exists to allow a recommendation to be made. (Formerly, these situations were captured under a "C Recommendation".) This change is not retroactive, and all "C Recommendations" made prior to 2003 have not been reevaluated in light of the new "I" recommendation grade. For a discussion of these recommendation grades, please link to the 2003 article in the Canadian Medical Association Journal here.
| MANEUVER | EFFECTIVENESS | LEVEL OF EVIDENCE <REF> | RECOMMENDATION |
| Electronic fetal monitoring (EFM) in high-risk* pregnancies. | Neonatal morbidity and mortality rates have not been definitely shown to be reduced with the use of EFM over intermittent auscultation. An increase in the ratesof cesarean section has been associated with EFM. | Randomized controlled trials <2-5> (I) | Weak evidence for either inclusion in or exclusion from the periodic health examination. (C) |
| EFM in low-risk pregnancies. | The use of EFM as compared with intermittent auscultation has not been shown to reduce neonatal morbidity or mortality rates but has been associated with increased rates of cesarean section andmaternal infection. | Randomized controlled trials <6-9> (I) | Fair evidence to exclude from routine intrapartum care. (D) |
* High-risk categories include: low gestational age, high maternal age, placenta of cord problems, meconium in the amniotic fluid, hypertension, proteinuria, malpresentation, poor outcome inprevious pregnancies and medical complications.
Link to Full Text of this review
Link to Structured Abstract of this review
Link to Selected References list of this review
Reprinted in modified format by the Canadian
Task Force on Preventive Health Care
with permission.
Original Copyright
© 1994 Minister of Supply and Services Canada.
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Last modified March 27, 1998.
