Routine umbilical cord gas analysis – is it worth it?
Routine cord blood gas analysis – harmful or helpful?
Digital fetal monitoring and ethics
I have lived through the rapid evolution of digital technologies. While digital tools offer new possibilities, they also raise ethical concerns, particularly with fetal monitoring. We need to talk about the ethics of digital fetal monitoring more than we currently are.
Is Australia on track to make birth safer?
In 2023, Australia recorded 218,099 births, with a rising cesarean section rate, now exceeding 40%. Induction rates and maternal age increased, while the perinatal mortality rate also rose to 11.0 per 1,000. Despite efforts to enhance birth safety, outcomes show concerning trends, necessitating reconsideration of the high rates of intervention.
Why bother?
If you have been hanging around Birth Small Talk for more than a moment, you’ll know I’m very focussed on putting the evidence about fetal heart rate monitoring in front of as many people as possible. And you’ll know that this position puts me at odds with a lot of what most people will hear in mainstream maternity services. So I get some pushback from time to time. And even […]
Human rights and artificial intelligence in healthcare
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.
Three things to stop saying about fetal monitoring
Terms like “happy,” “tired,” and “distressed”have no place in fetal monitoring discussions. Let’s use accurate language to describe fetal health, instead of emotional interpretations.
Are all fetuses the same?
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.
Would you let ChatGPT interpret your CTG?
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!
Does CTG monitoring during labour save lives?
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.
Being an “outstanding” maternity service means very little
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.
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