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The main aim of fetal monitoring is to timely identify and hence to salvage fetuses that are at risk of intrapartum hypoxic injury, whilst avoiding unnecessary operative intervention to fetuses that are normoxic or those who are mounting a good compensatory response. Cardiotocography (CTG) interpretation based on pattern recognition leads to unnecessary interventions as well as lack of action as all the CTG patterns of fetal neurological injury are not currently known and the specific CTG patterns do not correlate with poor neonatal outcomes. Intrapartum hypoxia should be suspected when there are changes in the baseline heart rate (i.e. below 110 beats per minute (bpm) or above 160 bpm) and/or presence of decelerations (on auscultation for 1 min after a uterine contraction) on intermittent auscultation. The decelerations are classified as early, late and variable in relation to the uterine contractions.