Continuous fetal monitoring (CFM) technologies are currently being developed for high-risk pregnancies. CFM includes monitoring fetal heart rate and movements. There are concerns about signal quality, and there is an urgent need for research to demonstrate whether CFM actually helps. What impact will it have on women and maternity professionals if it is implemented more widely?
A recent review examined the relationship between abnormal heart rate patterns in CTG monitoring and various neonatal outcomes. While some links were identified, particularly with hypoxic ischaemic encephalopathy, overall connections were weak. The evidence suggests CTG monitoring may not be as clinically useful as presumed, prompting calls for alternative monitoring methods.
A student in my Fetal Monitoring for Maternity Professionals course asked me about this recently – and I realised I had never written about it, despite having promised to do so a few times! This is for Natalie, with gratitude. What is the Dawes Redman system? As an Australia maternity care provider, I have never encountered the Dawes Redman system in clinical practice. Its use seems to be widespread in […]
This is the third post in a series I am writing about the Auscultated Acceleration Test or AAT. If you haven’t been following along and don’t know what this test is – you can read about it here. The goal of antenatal CTG monitoring is to predict which fetuses are at risk of a poor outcome relating to low oxygen levels, so action can be taken and therefore avoid death […]
Last week I explained what the AAT was. This week I want to share research that compared one midwife against another, to see if they were able to generate an accurate assessment of the fetal heart rate pattern, and were able to detect accelerations as reliably as a CTG machine. If you missed last week’s post and don’t know what I’m talking about – you can find it here. How […]
With thanks to Maryann Long, CNM, PhD, for bringing Lisa Paine’s work to my attention. I’m always fascinated about how some new ideas “stick” and are incorporated into practice, while others fall by the wayside. Despite having read widely about fetal heart rate monitoring options for the past decade, the Auscultated Acceleration Test never crossed my path. This simple approach seems to have fallen by the wayside. I want to […]
CTG monitoring during pregnancy is called non-stress testing in some parts of the world. This is to distinguish it from stress testing, where low doses of oxytocin or nipple stimulation are used to provoke contractions so the way the fetal heart rate responds to contractions can be observed. The term non-stress testing is rather ironic however, as there is a body of evidence showing higher levels of anxiety in women […]
There has been a lot of research about whether health professionals agree on what to call the pattern on a CTG during labour. And the experts all agree, that the experts don’t agree. That is to say, there is a troubling degree of variability in how maternity professionals interpret the same CTG pattern. This is something I have written about before (here, here, and here). Until recently, I had never […]
Sometimes I spot a new research paper and I ended up thinking – well that was something I never really thought about before! That was what happened when this one came my way. I’m pleased someone thought to do this research and I hope maternity professionals can adopt their practice with these findings in mind. How was it done? The paper has the slightly confusing title of “The effect of […]
While last week’s post questioned whether we should be doing antenatal CTGs at all, this week’s post explores the positive impact of a shift from referring women into obstetric care for antenatal CTG monitoring to providing this in primary midwife-led care. Maternity care in the Netherlands The Netherlands offers a very different approach to maternity care than most other high income countries. Midwifery care is very much accepted and supported […]
Birth Small Talk 