{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:44:45Z","timestamp":1792176285923,"version":"4.4.0"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Cardiotocography is a dual\u2010signal physiologic modality monitoring the pregnant and fetal patient. The objective of the present study was to compare global guidelines with the recently updated US Clinical Practice Guideline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comparative analysis was conducted across global guidelines and the US guideline, evaluating three domains: uterine physiology, fetal heart rate interpretation, and management models. Definitions, interpretive structures, and triggers for intervention were compared without attempting to reconcile divergent frameworks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Global guidelines (cardiotocography) define uterine activity across multiple physiologic parameters and integrate these with fetal heart rate to assess the maternal\u2013fetal unit as a single physiologic system. In contrast, the US guideline (fetal monitoring) defines tachysystole but does not explicitly define additional uterine physiologic parameters, and intervention is recommended when tachysystole is associated with fetal heart rate abnormalities rather than as an independent physiologic trigger. Global frameworks interpret fetal heart rate patterns within uterine context, whereas the US guideline emphasizes pattern recognition with limited formal integration of uterine physiology. These differences result in a preventive model in global guidelines and a comparatively reactive model in the US guideline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Intrapartum surveillance functions most effectively when uterine activity and fetal heart rate are interpreted as components of a maternal\u2013fetal physiologic system. The US guideline provides detailed fetal definitions but leaves most uterine physiologic elements unspecified. Reintegration of explicit uterine physiologic definitions may improve physiologic coherence and support earlier intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.71084","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T11:47:16Z","timestamp":1779882436000},"page":"840-845","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Global and\n                    <scp>US<\/scp>\n                    standards for intrapartum surveillance of the pregnant and the fetal patient"],"prefix":"10.1002","volume":"175","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0308-0232","authenticated-orcid":false,"given":"Amos","family":"Gr\u00fcnebaum","sequence":"first","affiliation":[{"name":"Northwell Health\/Zucker School of Medicine at Hofstra\/Northwell  New Hyde Park New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim","family":"Dudenhausen","sequence":"additional","affiliation":[{"name":"Northwell Health\/Zucker School of Medicine at Hofstra\/Northwell  New Hyde Park New York USA"},{"name":"Charit\u00e9 Universit\u00e4tsmedizin City Medicine  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank A.","family":"Chervenak","sequence":"additional","affiliation":[{"name":"Northwell Health\/Zucker School of Medicine at Hofstra\/Northwell  New Hyde Park New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,27]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1959.tb44593.x"},{"key":"e_1_2_10_3_1","first-page":"267","article-title":"Effects of abnormal uterine contractions on a human fetus","volume":"81","author":"Caldeyro\u2010Barcia R","year":"1963","journal-title":"Bibl Paediatr"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1961.16.3.573"},{"key":"e_1_2_10_5_1","first-page":"814","article-title":"Electronic evaluation of the fetal heart rate. VIII. Patterns preceding fetal death","volume":"87","author":"Hon EH","year":"1963","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_10_6_1","first-page":"137","article-title":"The classification of fetal heart rate","volume":"22","author":"Hon EH","year":"1963","journal-title":"I Obstet Gynecol"},{"key":"e_1_2_10_7_1","first-page":"1542","article-title":"New method for the selective registration of the fetal heart beat","volume":"22","author":"Hammacher K","year":"1962","journal-title":"Geburtshilfe Frauenheilkd"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00672168"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.08.025"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2015.06.024"},{"key":"e_1_2_10_11_1","unstructured":"National Institute for Health and Care Excellence.Fetal Monitoring in Labour. NICE guideline. Reference number: NG229. 2022. Last updated: 12 November 2025. In press. 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Data are from the Natality Records 2016\u20132024 as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed December 1 2025.http:\/\/wonder.cdc.gov\/natality\u2010expanded\u2010current.html"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000005447"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2023.02.009"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.02.046"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.04.026"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.19080\/GJORM.2021.08.555735"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2023.04.011"},{"key":"e_1_2_10_24_1","article-title":"Definitions and management of uterine tachysystole during labour: the need for a uniform approach. 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