电子胎心监护（EFM）可以反映实时胎心频率变化，是评估胎儿宫内状态的重要工具。在频繁宫缩背景下的产时EFM，与产前EFM的判读要点不同，且对产房决策有着重大影响。有新的证据表明，胎心基线稳定性和变异性与妊娠结局具有相关性，在判读产时EFM时需要重视。近年来随着国际产时EFM相关指南持续更新，产时EFM判读正从图形识别向病理生理机制分析转变，应结合EFM的特点、孕妇危险因素、合并症和产程情况，判断胎儿缺氧的类型、胎儿代偿与失代偿状态，进行个体化的EFM判读和胎儿宫内状态的评估，并针对性处理。这种判读理念有助于改善围产结局，保障母儿安全。

Electronic fetal monitoring （EFM） reflects real-time changes in fetal heart rate and serves as an important tool for assessing the intrauterine condition of the fetus. Intrapartum EFM performed against a background of frequent uterine contractions differs from antepartum EFM in terms of interpretive priorities and has significant implications for intrapartum decision-making. Emerging evidence suggests that baseline stability and variability of fetal heart rate correlate with pregnancy outcomes ，warranting increased attention in the interpretation of intrapartum EFM. In recent years，with the continuous updates on international guidelines for intrapartum EFM，the interpretation of intrapartum EFM is shifting from pattern recognition toward pathophysiological mechanism analysis. Individualized interpretation of EFM and assessment of intrauterine fetal condition should be achieved based on EFM characteristics，maternal risk factors，comorbidities，and labor progress，identifying the type of fetal hypoxia and fetal compensatory and decompensatory status and implementing targeted management. This approach of interpretation contributes to improving perinatal outcomes and ensuring maternal and fetal safety.