The First Cesarean: Role of "Fetal Distress" Diagnosis

Maged M. Costantine, George R. Saade

Research output: Contribution to journalReview articlepeer-review

20 Scopus citations


The goal of this review is to synthesize the available information regarding factors leading to the first cesarean, especially as it relates to the role of electronic fetal heart rate monitoring (EFM) in the prevention of the first cesarean. The widespread use of EFM did not reduce perinatal or neonatal adverse outcomes. Coupled with its inherent problems, such as poor sensitivity and reliability, this has led to a dramatic increase in cesarean delivery rates. To be realistic in any attempt to lower the current cesarean rate, we must address the inherent limitations in our current EFM methods.

Original languageEnglish (US)
Pages (from-to)379-383
Number of pages5
JournalSeminars in Perinatology
Issue number5
StatePublished - Oct 2012
Externally publishedYes


  • Cesarean delivery
  • Electronic fetal heart rate monitoring
  • Fetal blood sampling
  • Fetal electrocardiogram
  • Fetal pulse oximetry
  • Perinatal and neonatal adverse outcomes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology


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