[Place of fetal heart rate monitoring and its computerized analysis during the surveillance of prolonged pregnancy]

Objectives: To determine the place and the respective value of both visual and computerized analysis of cardiotocography (CTG) during the surveillance of prolonged pregnancy, to show their potential impacts on the obstetric care according to their results and their possible integration in the surveillance programs of prolonged pregnancies while awaiting better cervical conditions or spontaneous labour.

Materials and methods: Bibliographic research by consulting database of both Pubmed and Cochrane Library.

Results: In the case of prolonged pregnancy, CTG is the first line examination for the detection of antepartum asphyxia. In the case of prolonged pregnancy, the predictive criteria of acidosis remain unchanged. The use of computerized CTG analysis instead of visual analysis is a possible alternative as it enables to reduce the length and the repetition of the CTGs. It has however not proved its superiority over visual analysis in improving the overall perinatal prognosis of prolonged pregnancies.

Conclusion: In the case of fetal surveillance in prolonged pregnancies without risks associated, evidence is lacking to attest that the use of visual and computerized CTG analysis improves perinatal prognosis. CTG plays all the same a dominating role in surveillance programs and remains used in the first intention. The contraction stress test and the fetal vibroacoustic stimulation test have not demonstrated their usefulness in this indication.