What FHR assessment is preferred after 42 weeks gestation due to increased fetal risk?

Electronic Fetal Monitoring (EFM) is the preferred method of fetal heart rate (FHR) assessment after 42 weeks of gestation primarily due to the increased risks associated with post-term pregnancy. As gestation extends beyond the typical 40-week mark, there is a higher likelihood of complications such as meconium aspiration, decreased amniotic fluid levels, and placental insufficiency, which can all adversely affect fetal well-being.

EFM allows for continuous monitoring of the fetal heart rate and detection of any abnormal patterns, providing valuable insights into the health of the fetus. This method is particularly useful in high-risk situations, as it can quickly alert healthcare providers to concerning changes in the fetal condition, enabling timely interventions if necessary.

In contrast, intermittent auscultation (IA), though useful in many scenarios, may not be sufficient in the context of increased fetal risk associated with post-term pregnancies. Intermittent assessments do not provide the same level of continuous data or allow for immediate responses to significant changes in fetal status. Therefore, EFM is favored in this situation to ensure comprehensive monitoring and better outcomes for the fetus.