Popular fetal monitoring method leads to more c-sections


This is not new news; we have known for some time that electronic fetal monitoring leads to more caesareans. This article confirms what we know. In my practice, women do not have routine electronic fetal monitoring in labour. I listen to the baby with a hand-held, water-proof doppler and this is an unobtrusive method that can be used while the woman is in the bath or shower or in any position.

Pregnant women in labor, upon arriving at the hospital, will often have their baby’s heart rate monitored to assess the baby’s wellbeing. A new research review suggests that the use of one popular method of monitoring does not improve maternal and fetal outcomes and makes women more likely to have cesarean sections ...

The new review ... looked at how each type of monitoring affected women admitted to the hospital in labor with low-risk pregnancies and found there was no benefit of using the CTG at admission. However, women who had an admission CTG were about 20 percent more likely to have a caesarean section compared to those monitored by intermittent auscultation.

... about 79 percent of maternity wards in the United Kingdom, 96 percent in Ireland and all of the labor units in Sweden employ an admission CTG.

The review included four studies of more than 13,000 women randomized to receive either CTG or intermittent auscultation upon their admission with signs of labor.

“Our findings support recommendations from professional bodies in some countries that state the admission CTG not be used for low-risk women,” ...

... “We now know that this form of monitoring has not improved clinical outcomes,” he explained. “Instead, because of its inherent limitations, this form of monitoring leads to many ‘false alarms’ that are resolved by performing cesarean delivery.”

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