Acceptability of intrapartum cardiotocography using wireless transabdominal fetal ECG and electrohysterography: A...

To compare patient and staff acceptability of intrapartum cardiotocographic (CTG) monitoring using wireless transabdominal fetal ECG (TAfECG) plus electrohysterography (EH) with conventional wireless CTG, using Doppler ultrasound (US) and tocodynamometry (TOCO).

This was a prospective observational study, carried out in a tertiary care university hospital, between January and June 2023. A total of 264 labouring women with singleton pregnancies at term, in cephalic presentation, and more than 18 years of age, undergoing wireless CTG monitoring with wireless TAfECG + EH or US + TOCO were evaluated. A 10-point Likert scale patient satisfaction questionnaire was given to all participants in the early postpartum period. A second questionnaire evaluated 264 opinions of healthcare professionals regarding the two methods.

Women reported more favourable satisfaction scores with TAfECG + EH regarding comfort of use, ease and freedom of movement, skin irritation, and ability to rest in labour. Healthcare professionals reported a more favourable evaluation of TAfECG + EH regarding patient comfort during application, signal loss with mobility, ease of interpretation of contraction signals, and ease of interpretation of FHR signals in the 1st stage. Conversely, this technology was found to be more difficult to apply and to take more time to obtain an interpretable FHR signal. These aspects were evaluated more favourably after healthcare professionals had gained more experience with the method (p < 0.0001). The likelihood of women recommending the technique to others was similar between TAfECG + EH (81.2 %) and US + TOCO (81.1 %). Changing the CTG acquisition method occurred in 33.8 % of TAfECG + EH group and 9.1 % of US + TOCO group.

Wireless CTG monitoring with TAfECG + EH is well accepted by both labouring women and healthcare professionals, it is judged to be more comfortable for women than US + TOCO, and to allow greater mobility. However, in about a third of the cases it needs to be changed to another acquisition method during labour.