Cardiotocograph monitoring
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.
The development of the cardiotocograph (CTG) in obstetrics evolved from earlier fetal monitoring methods over a century. While intended to enhance fetal safety, its integration shifted focus towards legal liability and technology reliance, often undermining maternal care. Concerns about research integrity and the effectiveness of CTGs suggest the need to reassess their use in maternity care.
From time to time, I encounter women saying some version of “I’ll only have (insert birth intervention here) if it is medically indicated“. I completely understand the sense in which this is meant – that if something bad is highly likely to happen, and the proposed intervention is highly likely to stop that bad thing happening, then it makes sense to choose the intervention. People use this language as short […]
The third part of a series critiquing common myths about fetal heart rate monitoring. It emphasises that fetal monitoring is not essential for good outcomes, and intermittent auscultation IS fetal monitoring.
Does CTG misinterpretation harm babies? Or is something else going on?
Today’s post shares the back story behind our paper. #CTG #EFM #PerinatalMortality #CP
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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 […]
Fetal monitoring guidelines around the world recommend CTG use in labour when women are considered to be a higher risk for a bad outcome for the baby that is linked to low oxygen levels in labour. Regular readers of my blog will have seen me write repeatedly about the lack of great evidence to back this up. There’s no compelling research showing better outcomes with CTG use for women planning […]
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 […]
Birth Small Talk 