[Interval CTG monitoring in labor; a contribution to family-oriented labor in the clinic or a danger to the child?].
Instead of continuous CTG monitoring lasting from the onset of labor to delivery, various obstetricians recommend interval monitoring in cases designated "likely to be free of complications". This enables the mother to move freely from time to time without being permanently confronted by technological apparatus. In the study reported here the authors therefore investigated whether-and if so what-risks interval monitoring involves. In order to answer this question 436 cardiotokograms recorded during labor with externally and internally attached leads were analyzed, evaluated 30 CTG minutes after the Hammacher Score in each case, and the number of points thus obtained was assigned to the corresponding cervical widths. As labor progressed from 3 to 10 cm cervix dilatation, there was a fourfold increase (p less than 0.0001) in particular in tentatively pathologic and prepathologic CTG patterns. No statistically significant difference was found between no-risk and risk patients. A check was also made as to whether the results of interval monitoring are as good as those of continuous monitoring. On the basis of two patient populations with different interval monitoring frequencies (17% versus 6.4%) it was established that with high interval monitoring frequencies the perinatal results were poorer: early morbidity of the newborns was twice as high when interval monitoring was used more often (21.4% versus 10.8%) (p less than 0.0001). From this the authors conclude that for the sake of the child, continuous monitoring during labor ought not to be dispensed with.
Behrens
O
O
Frauenklinik der Medizinischen Hochschule Hannover.
Goeschen
K
K
Schneider
J
J
D000328:Adult; D005260:Female; D005316:Fetal Distress / Q000175:diagnosis*; D005323:Fetal Monitoring / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000401:mortality; D009321:Natural Childbirth / Q000379:methods*; D011247:Pregnancy; D012307:Risk Factors
CTG-Intervall-Uberwachung unter der Geburt; ein Beitrag zur familienorientierten Klinikgeburt oder eine Gefahr fürs Kind?