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Dear All, I work in a Birthing Centre; which is physically next door to a labour ward with centralised monitoring. My view is that the use of fetal scalp clips has increased to prevent loss of contact as this of course sets off the alarm bell, which is very annoying for those at the desk. This is also very distressing for those in the room as people who are watching the trace at the desk keep checking on what is happening in the room, this disturbs the room even more than having a CTG in progress. My view is that the labour may be “managed” by those at the desk not assisted by those who are observing the woman and her baby. Another personal view is that if a CTG is showing a “non-reassuring” trace the midwife in the room may wrongly presume someone at the desk has seen this and there is the potential of a delay in reacting to a trace when this is necessary. I feel the only time there may be a place for centralised monitoring in those cases where monitoring of the baby is required such as after a motor vehicle accident (I know this is not always considered necessary, but hospital practice may be this). If continuous monitoring in labour is required there should be a midwife in the room also. Keeping the traces is another issue as I believe with the benefit of hindsight an expert witness can always be found who will point out some defect in the trace and say it was not interpreted properly at the time so the trace is merely recording evidence to use against the hospital/Dr/Midwife. Centralised monitoring just seems to exaggerate all the bad points of continuous monitoring. All these above issues of course depend on the people involved but this is my observation. Regards Christine -----Original Message----- From: A forum for discussion on midwifery and reproductive health research. [mailto:[log in to unmask]]On Behalf Of Joy Kemp Sent: Thursday, 9 January 2003 1:44 AM To: [log in to unmask] Subject: Centralised CTG monitoring Dear All It is proposed in my unit to introduce centralised CTG monitoring for the labour ward. The rationale given by the lead consultant and clinical risk manager (midwife) for this is that CTGs will then be recorded and archived electronically, so will be available for review purposes indefinitely. I know of one piece of research done recently in which video cameras were used to collect data, but cannot recall the name of the researcher or whether this has yet been published. Can anyone enlighten me, and/or point me to any other work which has been done on the subject. For those who have worked with such a system, please would you also let me know your thoughts on whether centralised monitoring empowers or seeks to control midwifery practice and whether there are any other issues we may need to be aware of. Many thanks Joy Kemp