Clinical overview of cardiotocography

Twenty years after its widespread introduction, the role of continuous fetal heart rate and contraction monitoring in labour (cardiotocography, CTG) remains uncertain. Although a normal pattern is very reassuring about fetal condition, the predictive value of an abnormal pattern is low. In most studies the use of CTG has been associated with an increase in intervention in labour, particularly caesarean section, without clear evidence of benefit. Fetal blood sampling is the most useful associated technique for minimizing unnecessary intervention. The relationship between fetal heart rate, fetal blood pH changes and long-term outcome remains obscure and further work to clarify this relationship is urgently needed.