Electronic fetal monitoring
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.
This study explored women’s experiences with antenatal CTG monitoring and their understanding of its purpose. It revealed limited information was shared by healthcare professionals, leading to inadequate informed consent. It’s a great reminder of how important it is to have access to accurate information that supports decision-making regarding fetal monitoring.
Let’s talk about the history of how CTG use rose to prominence in maternity care. It has something to do with ultrasounds, moon exploration, washing machines, President Kennedy’s son, and husbands in birth rooms…
Fetal monitoring affects women’s autonomy in childbirth by influencing their freedom of movement. A survey of Australian midwives revealed that continuous CTG monitoring restricts mobility, while intermittent auscultation is underused due to barriers. Solutions are right in front of us, easy to achieve, and not expensive.
Three strikes and you are out! How a guideline meant to make maternity care safer undermined good communication.
Maternity professionals often find comfort, competence, and control in CTG monitoring. Transitioning to intermittent auscultation requires that we address these emotional attachments. My suggestions on how to achieve this are in this week’s blog.
A new study examined neurological outcomes in children born via caesarean section due to non-reassuring fetal monitoring. They found no differences in the rates of neurological problems when compared with caesarean done for non-progressive labour. The authors conclusions implied one possible reason for this – but there are other ways to interpret these results.
Myths about fetal heart rate monitoring are plentiful. Here are twenty of them. Let me know if there are others you would like to see me tackle!
It’s time to highlight the serious issue of unconsented fetal monitoring during childbirth, and the widespread misinformation about its safety and efficacy. It’s time to fix the underlying causes – starting with how guidelines are applied in practice.
Analysis of the RANZCOG Intrapartum Fetal Surveillance guideline reveals significant changes between the 3rd and 5th editions. Key improvements include clear responsibility shifts to clinicians, realistic evidence levels for CTG use, and better evidence organization regarding risk factors.
Birth Small Talk 