There are some major limitations of continuous CTG monitoring during labour. Recent studies exploring fetal heart rate and contraction patterns fail to identify patterns that reliably predict problems. Maybe we need to stop and head in a different direction altogether…
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.
Postpartum bleeding poses significant health risks. The WOMAN-2 trial found higher postpartum haemorrhage rates with episiotomy. CTG use could be driving up the rate of heavy bleeding – but what does the research say?
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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.
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.
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.
Routine cord blood gas analysis – harmful or helpful?
The paper assesses the performance of four Large Language Models for interpreting CTG traces of pregnant women. None of them were fit for purpose. Invest in learning about fetal physiology and how to interpret heart rate patterns and don’t delegate this to a computer!
The UK has experienced ongoing maternity care crises. A study of UK maternity services showed that quality ratings did not correlate with maternal and neonatal outcomes. It is time to question the effectiveness of current quality assessment processes and measures.
Continuous fetal monitoring (CFM) technologies are currently being developed for high-risk pregnancies. CFM includes monitoring fetal heart rate and movements. There are concerns about signal quality, and there is an urgent need for research to demonstrate whether CFM actually helps. What impact will it have on women and maternity professionals if it is implemented more widely?
Birth Small Talk 