Randomised trials are not the only evidence, and for some questions they may not be the bestBMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k662 (Published 14 February 2018) Cite this as: BMJ 2018;360:k662
- Jim Thornton, professor of obstetrics and gynaecology
- University of Nottingham, Maternity Unit, Nottingham City Hospital, Nottingham NG5 1PB, UK
Further to the debate on continuous electronic fetal heart rate monitoring,1 neither electronic fetal monitoring nor intermittent auscultation has ever saved a baby or harmed a mother directly. What saves (or harms) is intrauterine resuscitation or delivery.
The trials of monitoring versus intermittent auscultation are difficult to interpret because none of them specified how obstetricians and midwives should respond to different heart rate patterns; it was just assumed that they knew what to …