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A framework for standardized management of intrapartum heart rate patterns. Parer and Ikeda  AJOG  July 2007   26.e1 

ACOG Practice Bulletin:  Management of Intrapartum Fetal Heart Rate Tracings.   Number 116, November 2011.



The 2008 National Institue of Child Health and Human Development Workshopt Report on Electronic Fetal Monitoring.  Macones et al.  O&G September 2008


The 5-tier system of assessing fetal heart rate tracings is superior to the 3-tier system in identifying fetal academia.  Coletta et al.  AJOG March 2012 226.e1


Assessment of the concordance among 2-tier, 3-tier, and 5-tier fetal heart rate classification systems.  Bannerman et al.  AJOG September 2011. P 288



Intrapartum management guidelines based on fetal heart rate pattern classification.  Okai et al.  October 2010. Journal of Obstetrics and Gynaecoloty Research.


Observation on validity of the five-tier system for fetal heart rate pattern interpretation proposed by Japan Society of Obstetricians and Gynecologists.

Sadaka et al.  December 2011.  J Maternal Fetal Neonatal Medicine.