ABSTRACT
A risk assessment is done on admission to the delivery suite. For low-risk women, the fetal heart may be auscultated intermittently using a fetal stethoscope (Pinard) or Doppler ultrasound (Sonicaid). For at-risk women, a CTG is mandatory on admission. Continuous electronic monitoring is required in the following situations: epidural sited, syntocinon infusion in progress, fresh meconium-stained amniotic fluid, and so on. Auscultate for 60 seconds, beginning immediately after the end of a contraction, every 15 minutes in the first stage of labour and every 5 minutes in the second stage. If any fetal heart rate abnormality is identified then monitoring should be continuous and, where necessary, an FSE should be applied. The coordinating midwife should be informed; if she/he is not happy then the doctor on call should be asked to review. Any midwife or doctor reviewing a trace should document on both the trace and the case notes, stating their findings and plan.
