Cardiotocograph monitoring
A Japanese research team compared human and artificial intelligence performance in analyzing CTG data to predict perinatal asphyxia. Clinicians slightly outperformed AI in accurately diagnosing affected babies. However, limitations raise concerns, emphasising the essential role of healthcare professionals over machines in maternity services.
Clinical Decision Support Systems (CDSS) aim to enhance maternity care by improving decision-making consistency and safety. A systematic review points out concerns over potential biases and the effectiveness of CDSS amid varying clinical contexts. More robust research is needed.
Today’s post reflects on a 1959 trial concerning “fetal distress”. It highlights findings that meconium was a critical indicator of poor outcomes, while abnormal fetal heart rates weren’t reliably predictive. Should we be reevaluating current obsessions with CTG use and focusing on alternative clinical markers?
The Fetal Monitoring Academy offers a comprehensive library of resources for fetal monitoring, merging previous courses and adding new modules. It operates on a subscription basis, providing ongoing access and a supportive online community, the Common Room, for collaboration. Enrol before February 19, 2025, for an early bird discount.
In a trial comparing fetal blood sampling to digital fetal scalp stimulation for assessing fetal wellbeing, recruitment fell short, concluding early after just 534 participants. Despite showing a significantly lower caesarean section rate with scalp stimulation, the small sample limits the findings. The irony of guidelines undermining evidence development is discussed.
Prevalence-induced concept change is a psychological phenomenon where the meaning of a concept shifts due to declining frequency of related events. Over time, the definition of “high risk” in maternity care has expanded despite reduced perinatal mortality, leading to shifts in CTG usage.
A comprehensive literature review by researchers in the UK examined the safety of CTG monitoring in maternity care, identifying prominent system-level issues, including unsafe organizational cultures and inadequate staffing. It is import to focus on staffing, supportive environments, and respectful care to improve outcomes rather than unproven practices.
2024 was a big year for me. And 2025 looks set to be even more amazing! This is what I got up to this year, and what I have planned for the next.
This week I explore flawed beliefs in the effectiveness of fetal monitoring technology through a circular argument. It highlights three steps: assuming success when bad outcomes don’t occur, blaming individuals when they do, and declaring some cases unavoidable. It’s time the research to settle this was done.
Informed consent is a critical principle in healthcare. A recent Australian survey revealed that many women lacked sufficient information and choice about fetal monitoring methods. Only 35% reported being asked for consent. This highlights a significant issue in maternity care, and it is well past time it was addressed.
Birth Small Talk 