In almost all hospitals in developed countries, fetal monitoring is based on the cardiotocogram (CTG), which is the simultaneous registration of fetal heart rate (FHR) and uterine activity. The conventional CTG measuring technologies can be divided in two categories: invasive and non-invasive.
The invasive technologies provide reliable information on fetal heart rate and uterine activity, but their use is hampered by their invasiveness; they impose risks and can only be applied after rupture of membranes and sufficient dilatation of the cervix.
The non-invasive technologies do not have the disadvantages mentioned above and can also be applied earlier in pregnancy. However, the obtained information is often of low quality as the used techniques face difficulties in picking up the signal of the fetal heart and uterus.
After more than four decades of using CTG, perinatal mortality and morbidity rates have decreased only slightly. Unfortunately, CTG has also high rates of false positive and false negative predictions.
In case of a false positive prediction by CTG, a compromised fetus is predicted but the fetus is in a good condition. In such cases, many unnecessary medical interventions are performed, e.g. Caesarean sections and instrumental deliveries.
In case of a false negative prediction by CTG, a healthy fetus is expected whereas the fetus is in distress. In these cases, poor perinatal outcomes are faced, because the opportunity of timely intervention has been missed.
Therefore, there is a big need for a new fetal monitoring modality that accurately identifies compromised fetuses, without overtreatment of the normal ones. An alternative approach to obtain information about both fetus and uterine activity in a safe way, providing accurate results could be non-invasive electrophysiology.