Women’s Psychosocial Outcomes after Receiving Cardiotocography (CTG) or ST-Analysis (STan) Fetal Monitoring During Labour: An Australian Pilot Randomised Control Trial

Abstract

A common intervention to ensure the health of the fetus and mother during labour is electronic fetal monitoring (EFM). Standard practice for EFM in Australia is cardiotocography (CTG), which has a high false positive rate leading to unnecessary intervention such as caesarean delivery. The Women’s and Children’s Hospital is currently trialling a new technology, ST-Analysis (STan), which is used in conjunction with CTG. STan provides greater information to clinicians, allowing for more precise decision making thus leading to fewer unnecessary emergency caesareans. As a result, better outcomes such as lower levels of mental illness and better physical health are anticipated in the postnatal period. This pilot study aims to compare women via a randomised control trial on psychosocial outcomes after receiving either STan or CTG-only. No differences were observed between the treatment groups on satisfaction with EFM, early labour experiences and care. Based on thematic analysis on the positives and negatives of EFM, six themes were reported: perceived clinical errors, concern about EFM, experiences with staff, reassurance, comfort and more clinical information allowing for better decision making. When compared on mental and physical health outcomes, there was no variation between the two treatment groups except on subjective mental health, where the CTG-only group exhibited better mental health outcomes. Based on this pilot study, there seems to be no psychosocial advantage of including STan in the labour ward, however, more research is needed to replicate these findings.