Recommendation ID
CG190/5
Question
What are the natural frequencies of the avoidable harms that cardiotocography is intended to prevent for women who are assessed as being at low risk of complications at the start of labour? Does using cardiotocography in labours where complications develop confer a net benefit compared with intermittent auscultation?
Any explanatory notes
(if applicable)
Cardiotocography is used in current practice to monitor the fetal heart rate when there is a concern that fetal hypoxia may develop. It is regarded as unethical, in most circumstances, to conduct clinical research where women whose labour is categorised as 'high risk' are not offered cardiotocography. There is therefore no high-quality evidence about the size of the benefit or harm derived from the use of cardiotocography compared with intermittent auscultation, either in individual cases or across a whole population. Further analysis is needed to evaluate the actual(or probable) benefits and harms associated with this screening test. This would be based on analysis and modelling using data and assumptions derived from existing evidence from a range of countries, comprising data from any studies and/or historic data sets that record the natural frequencies of avoidable damage caused by intrapartum events. These data could then be used to ascertain both the natural frequencies of adverse events and whether widespread use of cardiotocography reduces these. Primary outcomes would be intrapartum fetal death, neonatal encephalopathy, cerebral palsy or other significant neurodevelopmental injury, and maternal morbidity. Other outcomes might include long-term physical and psychological outcomes (health across whole of life), health and social care costs, implications for informed decision-making, and
analysis of ethical considerations.

Source guidance details

Comes from guidance
Intrapartum care for healthy women and babies
Number
CG190
Date issued
December 2014

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No  
Last Reviewed 06/01/2015