Electronic fetal monitoring
Recent publications on fetal monitoring highlight the rise of artificial intelligence (AI) in interpreting CTG recordings. While advancements promise decision-support systems, rights issues remain. Ploug and colleagues emphasize the need for regulations in AI-driven healthcare to protect people’s rights, urging the integration of these considerations into technology development from the outset.
In the past two decades, standardized approaches to cardiotocography (CTG) interpretation have evolved. They don’t take into account that specific fetal heart rate patterns may vary by fetal sex and age. There is a need for individualised interpretation as standard guidelines may not account for all fetal characteristics, potentially leading to misinterpretation and harm.
The evidence on CTG monitoring vs intermittent auscultation during labour does NOT prove that CTG significantly reduces stillbirth or neonatal mortality rates, in either low or high-risk populations. Professionals and academics MUST avoid misleading people about the evidence.
Amnioinfusion is a procedure that delivers fluid into the uterus, aimed at improving fetal outcomes during labor, particularly when decelerations occur. A recent study found a significant reduction in total deceleration area post-amnioinfusion but lacked a control group. Caution is advised before widespread adoption of this practice.
The Dublin randomized controlled trial published in July 1985 aimed to determine the effectiveness of continuous fetal monitoring (CTG) over intermittent auscultation during labor. The trial found no significant differences in outcomes for babies. Despite its findings, CTGs remained widely used. It’s time to do something about that.
It’s a valid question. With at least 40 years of evidence showing that CTG monitoring doesn’t improve outcomes, wondering why we are still doing CTGs is a fair question. New research highlights why changing practice is so hard. And I share what I’m going to be doing to make it happen…
The article reviews a recent paper on fetal monitoring during labor by Richmond et al. which lacks a reference list, undermining its educational value. While it identifies some correct points about fetal heart rate interpretations, it perpetuates outdated practices and fails to acknowledge the need for consent in monitoring, thus serving more as promotional content than genuine education.
A recent Finnish study explored HIE and its preventability with CTG use. Findings suggest that timely interventions may have avoided HIE for one in five women with an affected. However, this study does not establish CTG superiority over intermittent auscultation for monitoring fetal health.
When is fetal monitoring not fetal monitoring? #EFM #CTG #LanguageMatters
In 2023, the MBRRACE-UK report showed an 18.3% decline in birth rates since 2013 with minimal improvements in mortality rates. Despite investment in maternal care, the rate of change in perinatal mortality rates is very slow and subject to outside influences. There is a strong need for effective intervention strategies.
Birth Small Talk 