Cardiotocograph monitoring
Fetal blood sampling has dropped out of practice, or reduced in use, in many parts of the world. It other places it remains a staple part of obstetric practice. This is a living example that far more than evidence alone is what drives practice. The evidence-base for fetal blood sampling was never very strong – and new research remains important to understand whether fetal blood sampling is a useful part […]
One of the fundamental requirements for any form of fetal heart rate monitoring is that the patterns that are detected MEAN something useful. In this week’s blog post I share yet another piece of research that should undermine blind faith in fetal monitoring practices.
In recent years, there’s been increased awareness about the possibility of confusion between maternal and fetal heart rates during CTG monitoring. This new research indicates that adding maternal heart rate data to the CTG might be having a negative impact on CTG interpretation. Read the details on the blog – including my suggestions for how to solve the problem.
A study by Roth et al. (2026) examined signal loss in external cardiotocography (CTG) during labor, revealing significant gaps in heart rate recordings. Findings indicated no clear correlation between these gaps and adverse outcomes for babies, challenging common beliefs about continuous monitoring.
Intermittent auscultation is a logical, evidence-based option for many women. But many women struggle to access it. New research provides insights about why that is the case in the UK – and offers some fairly easy to change possibilities to remove barriers.
Central fetal monitoring is sneaking its way in pretty much everywhere. Lots of people love it. Here are some of the reasons I have serious concerns about it…
Accurate information is essential for informed decision-making in fetal monitoring conversations. The myth that there is no, or very little, research about CTGs in population of women at higher risk has popped up again. Here’s the real story…
There are some major limitations of continuous CTG monitoring during labour. Recent studies exploring fetal heart rate and contraction patterns fail to identify patterns that reliably predict problems. Maybe we need to stop and head in a different direction altogether…
Central fetal monitoring systems, adopted globally, consolidate data on fetal heart rates and uterine contractions for real-time display. A Swedish study compared outcomes during traditional and central monitoring. No significant differences in metabolic acidosis or neonatal outcomes were found. Instrumental birth rates fell, likely due to revised guidelines, questioning the investment in central monitoring without definitive improvements.
Postpartum bleeding poses significant health risks. The WOMAN-2 trial found higher postpartum haemorrhage rates with episiotomy. CTG use could be driving up the rate of heavy bleeding – but what does the research say?
Comment BLOG and I’ll send you a link so you can find out.
Birth Small Talk 