This post is an introduction to ‘monitoring the fetal heart rate’ in NICE CG190 2014 (care of healthy women & their babies in labour & birth). I am going to assume a basic knowledge of the evidence and terminology. A post about ‘interpreting the fetal heart rate when using a CTG machine’ follows. For a more accessible introduction to the topic of monitoring in labour, you will find information from NICE here and here (note that it is a more general introduction – for women, whereas this blog is ‘a bit technical’ – it is about sharing how evidence is reviewed and recommendations are made. )
I am beginning blogging CG190 with monitoring of the fetal heart rate because, for me personally, the 2014 recommendations about CTG use felt very important, and some of the reviews of the research evidence really surprised me.
Also, NICE has decided to look at some of CTG evidence for both ‘low risk’ and ‘high risk’ populations as part of ‘Intrapartum Care 2 – care of women at higher risk of complications in labour & birth (‘IPC2’). Knowing that some of the CG190 ‘Evidence to Recommendations’ sections may be replaced by the deliberations of the IPC2 guideline development groups, I want to acknowledge the work done on looking at monitoring evidence (as it was in 2014) that the CG190 text represents. (28 May 2016, published 5 June 2016)
Chapter 10 of the Full CG190 guideline, on monitoring the fetal heart rate in labour, begins by comparing cardiotocography (CTG) and intermittent auscultation (IA). The text extracts I include here are from the Full guideline document.The recommendations are taken from the online version of the guideline. Continue reading →
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