Comparison of advanced electronic intrapartum monitoring system (Keyar device and Daksh application) with standard cardiotocography for assessment of fetal heart rate and uterine contractions

Background: Conventional cardiotocography (CTG) used for intrapartum fetal monitoring has limitations related to mobility, comfort, and usability, especially in low-resource settings. Noninvasive ECG-based monitoring devices offer a potential alternative. Objectives: To assess the accuracy, feasibility, and usability of the Keyar CM noninvasive intrapartum monitoring device compared with standard ultrasound-based CTG. Methods: A prospective observational study was conducted among 119 laboring women with singleton pregnancies at ≥32 weeks of gestation at AIIMS Bathinda. Simultaneous monitoring using Keyar CM and conventional CTG was performed. Baseline fetal heart rate, accelerations, decelerations, and uterine contractions were compared across four time intervals. Accuracy was assessed using percentage agreement and inter-rater reliability. Results: The average accuracy of baseline fetal heart rate, accelerations, decelerations, and uterine contractions recorded by Keyar CM compared with CTG was 96.80%, 80.36%, 93.98%, and 84.07%, respectively. The device demonstrated high agreement with CTG while allowing greater maternal mobility and comfort. Conclusion: Keyar CM shows comparable accuracy to conventional CTG for intrapartum monitoring and offers a portable, noninvasive, and patient-friendly alternative, particularly suitable for low-resource and high-burden settings.