Electronic fetal monitoring
I wrote this post back in February 2020 when this research was new. It’s a paper I often reference and use in my presentations. I’ve refreshed the post and am sharing it again because I think it contains valuable information. Research published this week by Chuey, De Vries, Dal Cin, and Low (2020) explored facilitators and barriers to the use of intermittent auscultation (IA) rather than CTG monitoring during labour. […]
Last week I shared two different research papers highlighting a link between epidural use and caesarean section for abnormal fetal heart rate patterns, pointing out that how these things were connected was not explained by this research. An independent group of researchers, based in Italy, have also recently published research in this area, and their findings provide some additional clues about what might be going on (Ghidini et al., 2023). […]
The journal Ultrasound in Obstetrics and Gynecology published two papers back to back recently. Both are from the same research team based in the Netherlands, and both examined the relationship between use of epidural pain relief during labour and the use of unplanned, in labour, caesarean section or instrumental birth for “presumed fetal compromise”. The research differed in the approach used. Together, the papers raise concern that epidural use might […]
One of the problems I see over and over again is the over simplification of complexities in relation to fetal heart rate monitoring in labour. Education and clinical guidelines tend to produce what appear to be logical and straightforward explanations and advice when there is a lot of mud in the pond. Here are two examples: In both of these cases the situations are much more complicated (like this and […]
Today’s post summarises the evidence about the use of admission CTGs.
I was all set to have a few weeks away from blog writing, when this Facebook post appeared over the weekend. I feel compelled to set out some actual facts about telemetry CTG monitoring to counter the claims made in this request for donations. Then I’m going to take a few weeks off! What is telemetry CTG monitoring? Standard CTG technology uses wires to connect the sensors on the woman’s […]
When you have been using a test for years and years, you assume someone way back at the beginning did some pretty decent research to determine what numbers are “normal” and a sign of good health, and what numbers are “abnormal” and a sign of poor health. But is that always the case? Why do we test cord blood acid levels? The testing of fetal and neonatal blood acid levels […]
Unlike Dr Who, we can’t drop into our future timeline to see what the consequences of our current decisions are. If we could, would we make different choices?
I was excited to see a new paper, setting out the evidence for intermittent auscultation in labour (Anderson, et al., 2023). It was published in a journal for US based nurse-midwives, so it relates to the context of care in that country. Let’s see how they did in terms of getting the facts right. Is their evidence accurate? They wrote that: All this is correct, except that one of the […]
Hypoxic ischaemic encephalopathy (or HIE) is a condition affecting newborn infants. As the name suggests, it relates to low oxygen supply (hypoxia), and / or reduced blood flow (ischaemia) causing damage (-pathy) to the brain (encephalo-). Other parts of the body might also show signs of damage from low oxygen, like the kidneys or the gut. It is diagnosed when there is a combination of high acid levels in umbilical […]
Birth Small Talk 