Intermittent Auscultation in Low Risk Labour (Green Pathway) – Midwifery Guidance, Obstetrics

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The goal of Intrapartum fetal monitoring is to detect and prevent the ill-effects of fetal hypoxia. There are currently two methods of monitoring fetal wellbeing in labour:

  • Intermittent auscultation (IA) using a Pinard or handheld Doppler
  • Continuous cardiotocography (CTG)

The method adopted is dependent on risk assessment and maternal choice. Women should be given evidence-based advice about fetal monitoring antenatally and should be involved in the decision making process (NHS Litigation Authority 2004).

Clinical practice guidelines only recommend continuous CTG for high-risk women (NICE 2014) and current evidence does not support the use of the admission CTG in low risk pregnancy (RCM 2012). Therefore, intermittent auscultation of the FH should be offered to low-risk women in established labour in all birth settings (NICE 2014).

NOTE: this guideline is hosted on the NHSGGC Obstetrics & Gynaecology Handbook website. Clicking on the link below will open the guideline in a new window.


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