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The use of telemetry in labour: Results of a national online survey of UK maternity units

02 January 2018
11 min read
Volume 26 · Issue 1

Abstract

Background

Guidelines from the National Institute for Health and Care Excellence recommend that telemetry is offered to any woman who needs continuous cardiotocography in labour.

Methods

An online survey of 168 maternity units in the UK was undertaken between November 2013 and February 2014 to determine how many units in the UK offered telemetry to women in labour and in what circumstances it was used.

Findings

The response rate was 62% (n=104). Some 63% (n=65) of responding units had at least one cardiotocography machine that could monitor the fetal heart via telemetry. Telemetry was used most often for women who had experienced a previous caesarean section and respondents felt that mobility and satisfaction with labour experience were most likely to be positively influenced by telemetry.

Conclusion

The survey gives an indication of how often and for whom telemetry is being used in the UK and describes the benefits that maternity units see for women using telemetry, such as increased choice and control.

Fetal heart rate monitoring in labour aims to identify fetuses who may be developing hypoxia, and allow timely intervention to prevent long-term poor neurological outcomes (Alfirevic et al, 2017). For most women who are healthy, have had normal pregnancies and no risk factors, evidence-based recommendations from the National Institute for Health and Care Excellence (NICE) are that the fetal heart rate can be monitored through intermittent auscultation every 15 minutes, using a Pinard or hand-held Doppler device (NICE, 2014). Continuous electronic fetal monitoring involves the use of two transducers (one to monitor the fetal heart and one to monitor uterine activity) attached to the woman's abdomen via leads and connected to a cardiotocograph machine (CTG). A continuous record of the fetal heart and uterine activity is recorded and printed. Continuous electronic fetal monitoring is recommended for women who enter labour with an underlying medical or fetal condition or in the event that complications develop during an otherwise low-risk labour. In the UK, approximately 60% of women will have continuous electronic fetal monitoring at some stage of their labour (NICE, 2014).

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