The shifting sands of medico-legal intra-partum Ctg (I-P Ctg) monitoring.
Intra-partum (IP) surveillance of the unborn child by cardiotacography (CTG) monitoring is the commonest obstetric procedure in the developed world.(1) It is also the most medico-legally contested obstetric procedure in labour. In 2011, 'birth asphyxia' comprised 50% of the UK National Health Service (NHS) litigation costs,(2) and in the 2000-2010 decade, the same NHS paid out £3.1 billion for maternity medico-legal claims (the highest of any speciality), mostly involving cerebral palsy and CTG misinterpretation.(3) This article looks at a number of characteristics of IP CTG monitoring which argue for its questionable solidity of base in court proceedings.
Mater Dei Hospital, Malta University of Malta, Malta george.g.buttigieg@um.edu.mt georgeb@maltanet.net.
George G
GG
Buttigieg
D015148:Cardiotocography / Q000592:standards; D003951:Diagnostic Errors / Q000331:legislation & jurisprudence; D005260:Female; D006801:Humans; D008318:Malpractice / Q000331:legislation & jurisprudence*; D011247:Pregnancy; D012680:Sensitivity and Specificity; D006113:United Kingdom
evolving language; high intra- and inter-observer error; high subjectivity; intra-partum CTG surveillance; low sensitivity; medico-legal; misinterpretation; shifting sands