Electronic fetal monitoring
Central fetal monitoring systems gather data from CTG machines and show it in a central place. While aimed at improving outcomes this has not been proven in research. Midwives reported disruptions in response to what was seen at the central monitor, leading to altered care practices focused on documentation over support for birthing women. It is time to pause and think, rather than continue to accept the introduction of these systems.
Women planning a vaginal birth after cesarean (VBAC) often seek to avoid negative experiences with CTG monitoring. This new mini-course offers reliable information on fetal monitoring options during VBAC, cutting risks down to realistic size, and providing communication strategies with care providers.
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.
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.
Birth Small Talk 