One of the problems I see with the evidence base relating to fetal heart rate monitoring during labour, is the focus predominantly on the immediate outcomes of birth. This is really obvious when you look at outcomes for the woman. The studies included in the Alfirevic et al., 2017 Cochrane review report on how women gave birth (caesarean section, instrumental birth, or spontaneous vaginal birth), whether they made use of […]
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?
Going to sleep lying flat on the back (supine position) has been linked to a higher rate of stillbirth between 28 weeks of pregnancy and the start of labour, with the chance rising closer to the end of pregnancy (McCowan, et al., 2017). Because of this, many countries now issue public recommendations about going to sleep in a side lying position in late pregnancy. The McCowan study also showed a […]
I’ve only just recently been to see the Barbie movie. It was fun, pink, sparkly, with a beautifully realised portrayal of Barbie Land, and excellent music. My daughter and I watched it in a middle of the day, middle of the week sitting and had the luxury of having the entire cinema to ourselves with the exception of one other woman. Very handy when you might end up singing along! […]
There’s a fair bit of controversy about whether, how, and when to test for diabetes in pregnancy. This post focusses on one decision women with a diagnosis of diabetes are often asked to make – when to give birth. (If you are after information about other aspects of diabetes in pregnancy, Rachel Reed and Sara Wickham both have great blogs about this, and both have books on induction of labour.) […]
Birth Small Talk 