The Admission test may help to identify those cases at risk in labour at the same time doing away with continuous monitoring . This involves performing a period of continuous EFM on admission in early labour. The rationale behind it is that it can assess the ability of the fetus to withstand the functional stress of uterine contractions during early labour. In the absence of acute events during labour, the admission test is a good screening test for predicting fetal well being and for classifying labour as a low risk one. If the admission test is reactive, a gradually developing hypoxia can be suspected by a rising fetal heart rate on auscultation7.
Fetal acidemia is a slowly developing event from the onset of changes in the fetal heart rate.
The fetus suffers from brain damage only when exposed to prolonged and profound hypoxia. In a gradually developing hypoxia, abnormal patterns may be present for 120 to 140 minutes before fetal acidemia increases significantly8. EFM is easy to apply and gives a reliable recording of fetal heart rate, however this does not translate into a better outcome. Its routine use is seen more often in busy labour units where one to one care is not available. Defensive practice in Obstetrics is common place and is one of the reasons for the routine use of EFM even in low risk pregnancies.