[Possibilities and value of discontinuous labor monitoring by cardiotocography. A retrospective study based on a...

The effectiveness of fictitious discontinuous intrapartum CTG monitoring was investigated and compared with available continuous CTG's by means of a retrospective analysis of 200 CTG tracings. CTG is a method of high sensitivity and offers, together with foetal intrapartum blood sampling, a possibility to detect foetal distress with high specificity and predictive value. From these CTG tracings the fictitious periods of time were assessed according to a certain schema to give women a possibility of being unrestricted in their activities without intrapartum monitoring while at the same time they were under satisfactory surveillance to notice sufficiently early any foetal distress that might lead to severe acidosis. The study was subdivided into 4 groups: Group 1: Patients at no risk during pregnancy and/or risk on admittance or during labour, no alarming signs from the foetus during the intrapartum period. Group 2: No risk, but with alarming signs from the foetus. Group 3: Patients at risk, no alarming signs from the foetus. Group 4: Patients at risk and with alarming signs from the foetus. The results suggest the possibility of discontinuous intrapartum monitoring according to a certain schema up to the second stage of labour, at minimum intrapartum risk for the baby, especially if there were no risks during pregnancy and at the beginning of delivery. According to these results 83% of all patients in labour would not have needed continuous CTG for more than half of the time spent in the labour ward. Only one in 6 deliveries (17%) would have required continuous monitoring.(ABSTRACT TRUNCATED AT 250 WORDS)