# Rethinking Electronic Fetal Monitoring to Improve Perinatal Outcomes and Reduce Frequency of Operative Vaginal and Cesarean Deliveries

> **NIH NIH R01** · STATE UNIVERSITY NEW YORK STONY BROOK · 2020 · $676,787

## Abstract

The essential role of electronic fetal monitoring (EFM) during labor is to prevent adverse outcomes due
to fetal hypoxia and ischemia. Its established weaknesses include: 1) the obstetrician’s highly subjective
visual interpretations of the signal patterns and 2) the widespread use of unproven surrogates for
relevant fetal hypoxic and/or ischemic injury such as umbilical arterial pH, intrapartum stillbirth,
newborn Apgar scores and neonatal seizures. This technology over the past 50 years has not been
shown to decrease stillbirths or reduce the numbers of infants with cerebral palsy. EFM as it is presently
used in the clinical setting has been associated with an extraordinary increase in the use of operative
vaginal delivery and cesarean delivery. No functional algorithm has yet been developed that integrates
clinical data collected in the antepartum period and during labor and any other patient specific data
with the results of EFM. The main objective of the proposed research is to use recent breakthroughs in
machine learning to drive the development of predictive analytics to support and improve the
interpretation of EFM data, especially under real world conditions and in real time where clinicians must
make timely decisions about interventions to prevent adverse outcomes. It is anticipated that the
proposed research will result in significantly decreased use of operative vaginal delivery and cesarean
delivery while more precisely defining the fetus at risk for developing metabolic acidosis and long term
neurologic injury.

## Key facts

- **NIH application ID:** 9928479
- **Project number:** 5R01HD097188-02
- **Recipient organization:** STATE UNIVERSITY NEW YORK STONY BROOK
- **Principal Investigator:** Petar M Djuric
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $676,787
- **Award type:** 5
- **Project period:** 2019-05-10 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9928479

## Citation

> US National Institutes of Health, RePORTER application 9928479, Rethinking Electronic Fetal Monitoring to Improve Perinatal Outcomes and Reduce Frequency of Operative Vaginal and Cesarean Deliveries (5R01HD097188-02). Retrieved via AI Analytics 2026-06-11 from https://api.ai-analytics.org/grant/nih/9928479. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*