Admission CTGs

An admission CTG is where the midwife uses an electronic fetal monitor to monitor the baby's heartbeat for a period of time when the woman is admitted to the delivery suite in labour. In years gone by, it was standard practice in hospitals across the country, but in recent years, it has fallen out of flavour.

An admission CTG is different to continuous monitoring, in that continuous monitoring is employed when the midwife or obstetrician has a concern about the baby, whereas an admission CTG is used when there are no concerns.

So what are the issues with an admission trace?

The first issue is that the more often we use a CTG, the more often we discover slight irregularities in the baby's heart rate patters that are highly unlikely to cause problems, but which cause midwives and obstetricians some concern.  Hence, it is often the case that the CTG that was only ever meant to be on for a few minutes after arriving, tends to stay on for the duration.  We know from lots of research that CTGs do not improve outcomes at all in healthy women, however they do increase the caesarean rate with no benefit to the baby.

The second issue is that the CTG tends to require that the woman remains still.  This can increase her level of pain and discomfort, prompting her to request pain relief that she otherwise may not have required.  Pain relief can often lead to other interventions such a medication to speed the labour, forceps delivery and episiotomy.

So in essence, an admission CTG serves to increase the rates of intervention in low-risk, healthy women, with no known benefit to the mother or baby.

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