Current methods of non-invasive fetal heart rate surveillance

Introduction: As accurate fetal evaluation during labor is essential, there is a continuous need for better noninvasive ways of monitoring. Electronic fetal monitoring (EFM) is an essential tool towards effective fetal assessment during labor, with the invasive Intrapartum ST Segment Analyses (STAN) system an early favorite. There are very few non-invasive EFM devices worldwide, with only two having Food and Drug Administration (FDA) approval. Methodology: This state of the science review focuses on the most recent available scientific data regarding the role of non-invasive EFM and its effect on perinatal outcomes. Results: The Monica AN24 system, FDA approved and comparable to an external Doppler CTG, is independent of maternal BMI. The Mind child Meridian monitor, the second EFM device with FDA approval, is comparable to STAN, but with up to 32 electrodes for improved accuracy it can be difficult for medical professionals to master. The Nemo System, new to the market, was found to be highly acceptable as a 24-hour monitoring device by pregnant women in a single inaugural pilot study. Discussion: Non-invasive monitoring technology is making progress but there are still issues with signal acquisition and quality that stem from the newfound mobility of the monitored pregnant women. The two FDA approved devices are promising with a few caveats and there are also new devices that aim to improve on the shortcomings of the leaders with promising advances in signal acquisition and processing via additional electrodes and setups.