title: Does cardiotocography have a role in the antenatal management of pregnancy complicated by gestational diabetes mellitus?
abstract: BACKGROUND
  Controversy surrounds the role of fetal cardiotocography (CTG) in the antenatal management of pregnancy complicated with gestational diabetes mellitus (GDM).
  
  
  OBJECTIVE
  The aim was to investigate whether antenatal CTG aids management in pregnancy complicated by GDM.
  
  
  METHODS
  A prospective audit of 1404 consecutive antenatal CTG in women diagnosed with GDM. Outcomes for all CTG were audited to determine whether CTG altered pregnancy management.
  
  
  RESULTS
  In women requiring combination therapy (diet and medication), 43 CTG were required to change management of a pregnancy. In women managed by diet alone with a secondary pregnancy complication, 161 CTG were required to change management. In women managed by diet alone with no secondary pregnancy complication, CTG did not change management.
  
  
  CONCLUSIONS
  Antenatal CTG is not recommended in women with GDM managed by diet alone with no secondary pregnancy complication. Antenatal CTG is recommended in women with GDM who require combination therapy (diet and medication). The role of CTG in women managed by diet alone with a secondary pregnancy complication should be based upon the nature of the complication.
authors.affiliation: Department of Obstetrics & Gynaecology, Joondalup Health Campus, Joondalup, Western Australia, Australia.
authors.forename: Timothy
authors.initials: T
authors.lastname: Jeffery
authors.affiliation: Women's and Babies Division, Women's and Children's Hospital, North Adelaide, South Australia, Australia.|Discipline of Obstetrics and Gynaecology, Faculty of Health, University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Rodney
authors.initials: R
authors.lastname: Petersen
authors.affiliation: Department of Obstetrics & Gynaecology, Joondalup Health Campus, Joondalup, Western Australia, Australia.|Institute for Health Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: Quinlivan
mesh_terms: D000328:Adult; D015148:Cardiotocography; D003131:Combined Modality Therapy; D016640:Diabetes, Gestational / Q000178:diet therapy* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008485:Medical Audit; D011247:Pregnancy; D011295:Prenatal Care; D011446:Prospective Studies
chemical_list: D007004:Hypoglycemic Agents
keywords: cardiotocography; cohort study; gestational diabetes mellitus; number needed to treat; pregnancy