Admission cardiotography increases obstetric intervention

Compared with Doppler auscultation of the fetal heart, admission cardiotography has no benefit on neonatal outcome in low risk women. In addition, it results in increased obstetric interventions, including operative delivery. Mires et al (p 1457) randomised 3752 women to receive either cardiotography or Doppler auscultation of the fetal heart when they were admitted in uncomplicated labour. There was no significant difference in metabolic acidosis or any other neonatal outcome in women who remained at low risk. However, those in the cardiotography group had an odds ratio of 1.26 for augmentation of labour, 1.33 for epidural anaesthesia, and 1.36 for operative delivery.

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Relevant Article

Randomised controlled trial of cardiotocography versus Doppler auscultation of fetal heart at admission in labour in low risk obstetric population • Commentary: changes between protocol and manuscript should be declared at submission • Commentary: research governance must focus on research training • Commentary: Approach to power calculations has to be realistic

Gary Mires, Fiona Williams, Peter Howie, Sandy Goldbeck-Wood, Gordon D Murray, and Britt-Ingjerd Nesheim
BMJ 2001 322: 1457-1462. [Abstract] [Full Text] [PDF]