Birth Small Talk

Talking about birth

Does CTG monitoring during labour work?

Photo by Matt Walsh on Unsplash

If you have read one of my blogs before, you’ll know that I have an interest in research around the use of CTG monitoring, particularly during labour. There’s a widespread misunderstanding about the evidence base, with many people who work in or make use of maternity care services assuming that CTG monitoring improves outcomes for the baby. This post summarises and signposts what I have written previously to make it easier for readers who might want to get across the research themselves.

  • Four things I wish everyone knew about CTG monitoring: This post contains a succinct summary of four key messages.
  • Does intrapartum CTG monitoring save lives? I am the primary author (along with Professor Mary Sidebotham, Professor Jennifer Fenwick and Professor Emeritus Jenny Gamble) of a systematic literature review examining the research about the use of CTG monitoring for women considered to be at high risk for poor perinatal outcome. This post summarises the key findings from our paper for those of you who are not able to access the paper from. And this one explains some of the backstory behind why we wrote the paper. Melanie the Midwife (Melanie Jackson) has produced a video summarising the findings for those of you who prefer to watch and listen rather than read.
  • More evidence that intermittent auscultation is safe: Since we published our review, another group of researchers has also produced an evidence summary. They extended their assessment beyond our more narrow focus on mortality and cerebral palsy. I have summarised their findings here.
  • But what about women with diabetes? I’m often asked about what research about CTG use says for women with specific risk factors. This post summarises a literature review completed by Jabak and Hameed that set out to look at evidence about CTG use for women with gestational diabetes. (You’ll also find a hint about the answer to all the “but what about women with …?” questions at the start of this post.)
  • Could CTG monitoring itself alter fetal heart rate patterns? This post looks at the first ever randomised controlled trial of CTG use during labour. Some interesting findings were included, that have never been further examined in research. They suggest that, yes, CTG monitoring might be linked to more fetal heart rate pattern abnormalities than intermittent auscultation.
  • A theory rather than research: Caroline Rogers has written an interesting paper setting out a theory that CTG use in labour might be linked to higher levels of autism. You can read my summary of her paper here.

There are still many questions about CTG use during labour that would benefit from good answers. Admitting that we still don’t know whether it works or not, nor even whether the physiological assumptions that CTG monitoring is based on are accurate or not, is the first step in solving the riddle.

Categories: Basics, CTG, EFM, Perinatal brain injury, Perinatal mortality, Stillbirth

2 replies

  1. Reblogged this on Flowerpower66 and commented:
    If you’re looking for information on the current evidence on CTG, read Dr Kirsten Smalls info blog.



  1. What are the gaps in our knowledge? – Birth Small Talk

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