Continual monitoring

The new NICE guidelines mentioned in the previous section have been very interesting. When they first appeared they had the recommendation that continual electronic fetal monitoring (CEFM), aka CTG (cardiotocograph), should not be offered for vbac, as there is no evidence to show it improves outcomes.

The Royal College of Obstetricians and Gynaecologists didn't like this and so the guidance was removed but this remains in the 'rationale and impact section of the NICE guideline for intrapartum care for women with complications:

“The committee was aware that continuous cardiotocography is usually advised for women in labour who have had a previous caesarean section. However, it is uncertain whether continuous cardiotocography in these circumstances allows risk to be identified sooner than if intermittent auscultation is used.”


CEFM is being challenged more and more. Australian obstetrician Kirsten Small has written a number of articles about the use of CEFM, and the lack of evidence that it helps.


At home Intermittent Auscultation (listening in periodically with a sonic aid/dopler or a pinard (ear trumpet)) is offered.

Your hospital may offer wireless telemetry. This is still continual monitoring, though wireless. This gives you more flexibility to move but some of the other problems of CFM.

Complete and Continue