Obstetricians and midwives have agreed a joint approach to electronic fetal monitoring, it has been announced.
Monitoring is extensively used when there is a risk of complications – but is also frequently cited in investigations as having been misinterpreted.
A joint statement between the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives says that monitoring should not be used alone to make clinical decisions, warning that it is often difficult to interpret.
The statement cites the factors that should be included in decision-making, including the mother’s history, the stage and progress in labour and antenatal risk factors.
It also backs the use of "fresh eyes" and the use of colleagues for regular review of fetal heart traces.
RCOG vice-president Edward Morris said: “Electronic fetal monitoring is an essential part of our toolkit for monitoring the wellbeing of a baby during labour, but the evidence doesn’t support its use for all women, and the results must never be interpreted in isolation of other factors that may influence how well a baby is coping with labour.
“Problems with accurate assessment of fetal wellbeing during labour, including interpreting fetal heart rate patterns, have been cited as a factor in many of the term stillbirths, neonatal deaths and severe brain injuries we reviewed as part of our Each Baby Counts programme.
“To ensure the safest possible maternity service, we recommend all units formally assess low risk women on admission in labour to determine the most appropriate fetal monitoring method, NICE guidance on when to switch between intermittent and continuous monitoring during labour is followed and all staff have documented evidence of appropriate annual training in fetal monitoring.”
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