Electronic fetal monitoring.

To the Editor.— We are writing in reference to the SPECIAL COMMUNICATION, "Impact of Electronic Fetal Monitoring on Obstetric Management" by Orvan W. Hess, MD (1980;244:682). Dr Hess' review is incomplete and biased, as well as inaccurate in some instances, recurrently demonstrating his position as an advocate of universal electronic fetal monitoring (EFM). It is difficult, for example, to understand why he omitted results from three of the four randomized controlled clinical trials (RCTs) of EFM. 1-3 He also inappropriately labeled Dr Wennberg's study an RCT (Dr Hess' reference 15). Dr Hess alludes to our work several times but fails to reference articles that appear in the scientific literature. 4-6 We think that it is only fair to offer readers the opportunity to judge what we have written and draw their own conclusions. After thorough review of the issues involved in EFM, we concur with the conclusion of the