Management of Abnormal FHR TracingsThe Goal of Continuous Fetal Heart Rate Monitoring During Labor: Have We Been Successful?ESPLIN, M. SEAN MD*,†Author Information *Department of Maternal Fetal Medicine, Intermountain Healthcare †Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah The author declares that there is nothing to disclose. Correspondence: M. Sean Esplin, MD, Suite 100, Salt Lake City, UT 84109. E-mail: firstname.lastname@example.org Clinical Obstetrics and Gynecology: September 2020 - Volume 63 - Issue 3 - p 601-606 doi: 10.1097/GRF.0000000000000543 Buy Metrics Abstract Despite its ubiquitous use, fetal heart rate (FHR) monitoring has not resulted in a significant reduction in hypoxic-ischemic encephalopathy following delivery. This manuscript reviews the reasons for this failure including limitations of FHR to accurately predict hypoxia, low prevalence of hypoxic-ischemic encephalopathy, and lack of standardization of interpretation and intervention. We propose an alternative goal for FHR monitoring during labor to provide optimal care by early identification of truly concerning features, initiation of appropriate interventions, clear documentation of concerns and plans, and clear communication between team members on labor and delivery, including initiation of the chain of command as needed. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.