08/08/2018 A-MEDEX

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Question ID 534

Title Bene ts of routine CTG monitoring on admission of women in maternity unit

Last revision 2018-05-24 12:29:58

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A 28-year-old woman is admitted to the maternity unit in early labor. She experienced
an uncomplicated pregnancy and is otherwise healthy. She asks you about fetal
monitoring during labor and says she has heard that cardiotocography (CTG) is helpful
for assessment of the baby’s wellbeing and preventing fetal problems. In counselling
regarding to the use of CTG as a predictor of fetal outcome and satisfactory labor in
comparison to intermittent auscultation and whether CTG monitoring will reduce the
risk of neonatal developmental abnormalities, which one of the following would be the
most appropriate advice?

A There is no evidence to support admission CTG.

B CTG is a predictor of previous fetal oxygenation.

C Compared to intermittent auscultation, CTG is superior in monitoring the

baby’s wellbeing.

D CTG is a good predictor of the fetal outcome.

E CTG will reduce the risk of neonatal developmental abnormalities.

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C G educe t e s o eo ata de e op e ta ab o
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a t es.

Option A is correct

Continuous fetal heart rate monitoring with CTG is mandatory in all high-risk pregnancies, but has
been shown to have limited value in low-risk pregnancies. Intermittent fetal heart auscultation has
the same e cacy in such pregnancies.

In fact, CTG in low-risk pregnancies, by recognizing abnormalities that are of little if any signi cance,
leads to unnecessary obstetrical interventions such as instrumental delivery or cesarean section.

CTG has not reduced the incidence of neonatal developmental abnormalities such as cerebral
palsy. CTG is a predictor of the current fetal condition, not the previous, unless there are severe
abnormalities as soon as the CTG is applied on admission.

In conclusion, there is no evidence to support routine admission CTG.

Reference(s)
http://www.ncbi.nlm.nih.gov/pubmed/22336808 (http://www.ncbi.nlm.nih.gov/pu
bmed/22336808)

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