The interaction between these systems results in a difference in the beat-to-beat intervals resulting in variability of the fetal heart rate tracing. In the term fetus, moderate variability is considered normal as it indicates a normally functioning central nervous system. During the first several pushes, the EFM demonstrated an initial heart rate deceleration, and a loss of signal, but the heart rate returned to a baseline rate of 150 BPM. With the patient’s continued pushing efforts, the EFM baseline increased to 180 BPM, with evidence of variable decelerations to a nadir of 120 BPM, although with some signal gaps ( FIGURE 1, red arrow). Electronic Fetal Monitoring: •Fetal heart sounds were first reported in the 1600’s •In the 1800’s, again described and used to determine viability and fetal lie. •1917 David Hillis in Chicago described the fetoscope, but in 1922 Joseph DeLee took the credit!