New methods of monitoring the baby’s heartbeat during labour perform no better than simpler methods in terms of ensuring safety, according to a new analysis.
The researchers, from Warwick Medical School, UK, compared the different methods of foetal surveillance that are routinely offered using a systematic review and meta-analysis.
The analysis included 33 trials with a total of 118,863 participants. A simple procedure called intermittent auscultation reduced the risk of emergency caesarean deliveries compared with other types of surveillance. This involves regular measurement of the baby’s heartbeat with a sonic aid or Doppler probe.
None of the newer methods – echocardiograms, blood tests and AI modelling – were more effective than intermittent auscultation for reducing the risk of adverse neonatal or maternal outcomes.
The team reported their study yesterday (6 April) in the Canadian Medical Association Journal.
Lead author, Dr Bassel Al Wattar, said: “Sadly, all the contributions we’ve done in this field for the last forty years are not yielding a significant benefit to make childbirth safer. The outcome of any labour should be a healthy mother going home with a healthy baby."
Co-author Professor Siobhan Quenby added: “We suspect that the problem with some of these monitoring methods is that they’re sending fake signals that the baby is compromised when it isn’t, and therefore a caesarean section is being performed to no clear benefit.
"It is important to note that our findings do not suggest that new monitoring methods are harmful or increasing emergency caesarean sections, but they are simply not helping to reduce them or improve childbirth safety compared to older, cheaper and widely accessible technology."
Al Wattar, B. H. et al. Effectiveness of intrapartum fetal surveillance to improve maternal and neonatal outcomes: a systematic review and network meta-analysis. Canadian Medical Association Journal 6 April 2021; doi: 10.1503/cmaj.202538
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