ADMISSION CARDIOTOCOGRAPHS

In the United Kingdom (UK), there is well documented evidence that labour care is dominated by technology interventions (Davis-Floyd & Dumit 1998, Sinclair 2001). One of the most common interventions is the use of Cardiotocographs.

The Cardiotocograph (CTG) is one form of fetal assessment that simultaneously records fetal heart rate (FHR), fetal movements and uterine contraction patterns (Nielson & Mistry 2000). Spencer (1992) also describes cardiotocography (CTG) as a composite record of fetal heart rate and uterine activity, which act as a diagnostic test of fetal condition whenever acute or chronic complications arise.

Monitoring of fetal heart rate became a widespread practice during the 1970s and has remained an accepted technique for assessing fetal well being in labour until relatively recently (Gauge & Henderson 2005). However, MacLennan (1999) and Thacker et al (2001) argue that the widespread use of CTG in the clinical practice has not been supported by substantial evidence.

The introduction of the Electronic Fetal Monitoring (EFM) ‘has been accompanied by confusion and difficulties with interpretation’ (Saling 1996) and ‘despite the fact that no clear evidence exists for its efficacy, especially in low-risk women’ (Murphy et al 1990) it has been integrated into maternity care, and uncertainty about its value remains (Neilson & Mistry 2000). Nevertheless, the aim of the introduction of CTG is to reduce the incidence of cerebral palsy and reduction of childhood neurological handicap caused by fetal asphyxia (Impey et al 2003). It also provides continuous indication of fetal response to uterine contractions and intervention (Spencer 1992)

Moreover, it provides baseline information for the midwife to interpret any periodic and episodic changes during labour (Martin Tucker 2004)

Therefore, the aim of this essay