INTRAPARTUM FETAL MONITORING PRACTICE IN THE UNITED KINGDOM

Summary

In September 1978 a postal survey was made to establish the influence of continuous fetal heart rate monitoring on clinical practice in 264 Consultant Obstetric Units in the United Kingdom. Replies were received from 244 units (92·4 per cent) and only one of these did not possess any fetal heart monitors. The approximate percentage of patients monitored during labour in these units displayed a bimodal distribution with peaks at 20 to 30 and 80 to 90 per cent, reflecting a division of opinion about the need to monitor all or only ‘high risk’ patients. For each hospital the ratio of the numbers of patients delivered during 1977 to the number of monitors was calculated and the values ranged from 172 to 2708. In nearly 25 per cent of the hospitals it was not possible to monitor all high risk patients. Fetal blood pH estimation was used in conjunction with fetal heart rate measurement in 98 hospitals (40·2 per cent) but 38 (15·6 per cent) had a pH meter in or adjacent to the labour ward although this was not used for pH estimation. Midwives were taught to apply fetal scalp electrodes in half of the units but were taught to collect fetal blood samples in only two. It is suggested that there is a need (i) to improve the monitoring facilities in many units, (ii) to encourage midwives to become more involved in practical monitoring techniques and (iii) to develop improved methods for fetal pH determination during labour.