Van Oudgaarden.

2 For patients in whom labor must be augmented or induced, monitoring through inner tocodynamometry might improve both maternal and fetal outcomes by allowing better adjustment of oxytocin, thus stopping uterine hyperstimulation and fetal hypoxia, or by enhancing the interpretation of unusual fetal heart-rate patterns with regards to uterine activity. However, clinical data to aid such hypotheses are limited, and recommendations are based on expert opinion. The latest statement by the National Institute of Child Health and Human Development working group on electronic fetal monitoring concluded that studies are had a need to assess associations between measures of uterine contraction and both fetal heart rate and clinical outcomes.4 We are alert to only three small, randomized clinical trials that compared internal tocodynamometry with external monitoring with respect to the clinical end result.5-7 None of these studies showed a substantial reduction in the rate of operative delivery or a significant improvement in neonatal outcomes with internal in comparison with external monitoring.