Fetal Welfare Assessment

Project Details

Project 1. There is currently an epidemic of caesarean sections performed in Australia and overseas. Although many caesarean sections are performed for concerns about fetal welfare, the majority of babies are shown to be well at birth, meaning that the operation, with its inherent short- and long-term risks, could have been avoided, without compromising the baby’s health. This project is a world-first randomised trial of fetal scalp blood sampling for lactate estimation during labour, with a view to reducing the caesarean section rate for apparently non-reassuring fetal status.

Project 2. It would be very helpful to be able to accurately monitor babies’ movements in the womb so that we could help the few babies who need it, and so prevent poor outcomes. Mothers feel their babies moving, but it is often difficult for them to detect all the movements that do occur. The best way of measuring babies’ movements is during an ultrasound. This is, however, expensive and means that the pregnant mother needs to lie still for about half an hour to have this testing done.

These may become tests that is easier to use and predicts outcomes as well or better than current monitoring methods.



  • Prof Christine East, Monash University
  • Clinical Assoc Prof Fabricio da Silva Costa, Monash Ultrasound


The research actiivities of the Pregnancy Research Centre (PRC) are funded by a variety of intramural and extramural sources. Since its formation in 1993, the PRC has secured over $15 Million in peer-reviewed, competetive national and international funding sources.

Research Outcomes

Recent publications relating to fetal welfare research in the PRC

East C E, Leader L R,Sheehan P, Henshall N E, Colditz P B, Lau R. Intrapartum fetal scalp lactate sampling for fetal assessment in the presence of a non-reassuring fetal heart rate trace. Cochrane Database of Systematic Reviews 2015; 2015, Issue 5.Art. No.: CD006174.

Boashash B, Khlif MS, Ben-Jabeur T, East CE, Colditz PB. Passive detection of accelerometer-recorded fetal movements using a time–frequency signal processing approach. Digital Signal Processing 2014; 25:134–155

Begg LB, Palma-Dias R, Wang J, Chin-Dusting JP, Skilton MR. Maternal adiposity and newborn vascular health. Arch Dis Child Fetal Neonatal Ed. 2013; 98(3):F279-F280

Charan P, Palma-Dias R, Walker SP, Ganeesamoorthy D, McGillivray G, Woodrow N. Molecular karyotyping: a revolutionary concept in prenatal diagnosis. Ultrasound. 2013; 21: 93

Menezes M, Meagher S, Da Silva Costa F. Ethical considerations when offering noninvasive prenatal testing. Rev Bras Ginecol Obstet. 2013; 35(5):195-198

Rocha RS, Bezerra SC, Lima JW de Oliveira, Costa F da Silva. Consumption of medications, alcohol and smoking in pregnancy and assessment of teratogenic risks. Rev Gaucha Enferm. 2013; 34:2(37-45)

Verburg BO, Steegers EAP, Fink AM, Reidy K, Palma- Dias R. Book chapter 'Fetal MRI' in E. Slager et al (eds.) Reproductive Medicine, Gynaecology and Obstetrics 2013; p473-479 (Dutch)

Walker SP, Palma-Dias R, Wood EM, Shekleton P, Giles ML. Cytomegalovirus in pregnancy: to screen or not to screen. BMC Pregnancy and Childbirth. 2013; 13:96

Cade TJ, Da Silva Costa F, Reidy K, Doyle LW, Mitchell SE, Palma-Dias R, Umstad MP. Pregnancy prognosis associated with an isolated single umbilical artery in twin pregnancy Twin research and human genetics. 2014; 17(6)584-599

Charan P, Woodrow N, Walker SP, Ganesamoorthy D, McGillivray G, Palma-Dias R. High-resolution microarray in the assessment of fetal anomalies detected by ultrasound.  Australian and New Zealand Journal of Obstetrics and Gynaecology. 2014; 54(1):46-52.

Ghali R, Reidy K, Fink AM, Palma Dias R. Perinatal and short term neonatal outcomes of posterior fossa anomalies. Fetal Diagnosis & Therapy.2014; 35(2):108-117

Kane SC, Da Silva Costa F, Brennecke SP. Recent developments in early pregnancy screening: are we getting closer to the Holy Grail? The Medical Journal of Australia 2014; 200(3):140-141

Al-Amin A, Hingston T, Mayall P, Araujo Júnior E, Costa F, Friedman D. The utility of ultrasound in late pregnancy compared with clinical evaluation in detecting small and large for gestational age foetuses in low-risk pregnancies. The Journal of Maternal-Fetal & Neonatal Medicine. 2015; 28(13):1495-1499

Alves JAG, Miyague AH, de Sousa PCP, Maia SB, da Silva Costa F, Martins WP. Brachial artery flow mediated dilation in the first trimester to predict the occurrence of hypertensive disorders during pregnancy. Fetal Diagnosis and Therapy. 2015; 37(4):316-320

Research Publications

East C E, Leader L R,Sheehan P, Henshall N E, Colditz P B, Lau R. Intrapartum fetal scalp lactate sampling for fetal assessment in the presence of a non-reassuring fetal heart rate trace. Cochrane Database of Systematic Reviews 2015, Issue 5.Art. No.: CD006174. DOI:10.1002/14651858.CD006174.pub3

East CE, Brennecke SP, Chan FY, King JF, Beller EM. Clinicians’ evaluations of fetal oximetry sensor placement in a multicentre randomised trial (the FOREMEOST trial). Australian & New Zealand Journal of Obstetrics & Gynaecology. 2006; 46:234 - 239.

East CE, Brennecke SP, King JF, Chan FY, Colditz PB; FOREMOST Study Group. The effect of intrapartum fetal pulse oximetry, in the presence of a nonreassuring fetal heart rate pattern, on operative delivery rates: a multicenter, randomized, controlled trial (the FOREMOST trial). American Journal of Obstetrics & Gynecology. 2006; 194(3):606, e 1-16.

East CE, Chan FY, Brennecke SP, King JF, Colditz PB. Women’s evaluations of their experience in a multicenter randomised controlled trial of intrapartum fetal pulse oximetry (the FOREMOST trial). Birth. 2006; 33:101-109.

East CE, Gascoigne MB, Doran CM, Brennecke SP, King JF, Colditz PB. A cost-effectiveness analysis of the intrapartum fetal pulse oximetry multicentre randomised controlled trial (the FOREMOST trial). BJOG: An International Journal of Obstetrics & Gynaecology. 2006; 113(9):1080-7

Research Group

Maternal Fetal Medicine Pregnancy Research Centre

Faculty Research Themes

Child Health

School Research Themes

Child Health in Medicine, Women's Health, Infectious Diseases and Immunity

Key Contact

For further information about this research, please contact the research group leader.

Department / Centre

Obstetrics, Gynaecology and Newborn Health

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