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June 12, 2026Frontiers in Drug Safety and RegulationOpen Access

Continuous FHR monitoring is linked to a ~67-minute shorter time from abnormal detection to delivery.

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Why the study?

The effect of implementing intermittent versus continuous fetal heart rate monitoring with Moyo on intrapartum care and neonatal outcomes remained unclear.

Does continuous fetal heart rate monitoring using the Moyo device reduce the time to delivery after abnormal FHR detection and improve neonatal outcomes in laboring women?

Population

1,091 control and 8,687 intervention participants across seven hospitals in Nepal

Comparison

Continuous fetal heart rate monitoring with Moyo vs intermittent monitoring

Design

Prospective observational study

Key result

Continuous fetal heart rate monitoring with Moyo significantly reduced the time from first abnormal fetal heart rate detection to delivery by 66.5 minutes compared to intermittent monitoring.

Authors

OBOmkar BasnetRGRejina GurungPBPratiksha Bhattarai

Discussion

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Overview

Non-significant reduction in time to abnormal FHR detection; does not support adoption and leaves efficacy open for further trials.

Key Points

  • This study evaluates the outcomes of intermittent versus continuous fetal heart rate monitoring in intrapartum care.
  • Prospective observational design across seven hospitals in Nepal
  • Intermittent monitoring served as the control, while continuous monitoring was the intervention
  • Generalized linear regression analyzed time to abnormal FHR detection and childbirth outcomes
  • Continuous monitoring resulted in a significant reduction of 66.5 minutes from first abnormal FHR to delivery (adj.β = −66.5 min; 95% CI = −106.2 to −26.8)
  • The incidence of non-crying neonates was lower in the continuous group (10.0% vs. 11.5%; M–H RR = 0.69; 95% CI = 0.55–0.87)
  • Adjusted risk of intrapartum stillbirth was reduced by 35% in the intervention group (M–H RR = 0.65; 95% CI = 0.25–1.70)

Study Design

Type

Observational (n=9,778)

Multicenter

Yes

Structured PICO

Does continuous fetal heart rate monitoring using the Moyo device reduce the time to delivery after abnormal FHR detection and improve neonatal outcomes in laboring women?

P
Population
9,778 women admitted to the labor unit, either not yet in labor or in the first stage of labor, monitored during childbirth across seven referral hospitals in Nepal.
I
Intervention
Continuous fetal heart rate (FHR) monitoring using the portable Moyo device until the time of delivery.
C
Comparator
Intermittent FHR monitoring using the Moyo device (every 30 min during the first stage of labor and every 15 min during the second stage).
O
Outcome
Time from first Moyo placement to abnormal FHR detection and time from first abnormal FHR detection to delivery.

Main Result

Mean Difference: -66.5 (95% CI -106.2–-26.8)

Absolute Event Rate: 73% vs 132.2%

p-value: p=0.001

Continuous fetal heart rate monitoring with a portable device reduces the time to delivery following abnormal FHR detection and decreases the need for neonatal resuscitation compared to intermittent monitoring.

Limitations

  • Blinding of care providers and participants was not feasible
  • Observational design with non-randomized exposure
  • Differences in monitoring modality inherently influence the frequency and timing of fetal heart rate assessment
  • Reliance on routine clinical documentation may introduce variability
  • Potential selection bias and unmeasured confounding
  • Monitoring frequency differed between continuous and intermittent monitoring periods as per study design
  • Low incidence of stillbirths may have underpowered the analysis for this outcome
  • Substantial imbalance between exposure groups and baseline differences

Cite This Study

Basnet et al. (2026) conducted an observational in Labor (n=9,778). Continuous fetal heart rate monitoring using Moyo vs. Intermittent fetal heart rate monitoring using Moyo was evaluated on Time from first abnormal fetal heart rate detection to delivery (adj.β -66.5 min, 95% CI -106.2 to -26.8, p=0.001). Continuous fetal heart rate monitoring with Moyo significantly reduced the time from first abnormal fetal heart rate detection to delivery by 66.5 minutes compared to intermittent monitoring.

synapsesocial.com/papers/6a2bd1056550ea4541ffe7aehttps://doi.org/10.3389/fdsfr.2026.1755487
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Implementation of a novel continuous fetal Doppler (Moyo) improves quality of intrapartum fetal heart rate monitoring in a resource-limited tertiary hospital in Tanzania: An observational study2018 · 44 citations
  2. 2Perceptions and experiences of skilled birth attendants on using a newly developed strap-on electronic fetal heart rate monitor in Tanzania2019 · 20 citations
  3. 3The effect of continuous electronic fetal monitoring on mode of delivery and neonatal outcome among low-risk laboring mothers at Debre Markos comprehensive specialized hospital, Northwest Ethiopia2024 · 2 citations
  4. 4Implementation barriers and facilitators of Moyo foetal heart rate monitor during labour in public hospitals in Nepal2024 · 2 citations
  5. 5Unexpected Term Neonatal Intensive Care Unit Admissions and a Potential Role for Centralized Remote Fetal Monitoring2021 · 7 citations