Intrapartum hypoxia was thought to contribute to the incidence of cerebral palsy, seizures and mental retardation. Electronic fetal monitoring was expected to prevent or reduce this incidence. Electronic fetal monitoring has a high false positive rate and fetal blood sampling, which is an invasive procedure, only allows an intermittent assessment. Efforts are being made to improve fetal heart rate analysis and clinical management. Fetal pulse oximetry, fetal electrocardiogram waveform analysis and the intermittent measurement of lactate levels by fetal blood sampling may become established as an adjunct to electronic fetal monitoring.