Dear all,
In the Netherlands, we are looking into using CTG monitoring in a birth centre for women with midrisk indications, such as prolonged ruptured membranes or pain medication. Midwives will only look after women with a normal CTG tracing and will transfer care to an obstetrician if the CTG is suboptimal or worse. However, during second stage the majority of CTG tracings are suboptimal, looking at the modified FIGO criteria. But in most of these cases the neonatal outcome is very good. Practitioners are not worried about all of these CTG traces and, for example, would not perform fetal blood sampling or consider expediting the birth in all cases. Does anybody know of specific criteria for CTG interpretation during second stage that are used in practice? Or are these decisions based on clinical experience only?
The value of CTG for many of these midrisk indications is another area of debate of course. For now, we aim to improve continuity of care for women by expanding the scope of practice of midwives while maintaining the current protocols for indications for CTG monitoring.
Thank you very much,
Ank de Jonge.
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