Use of intrapartum cardiotocography in low-risk pregnancies: A cross-sectional study

Background There is limited knowledge about the extent of intrapartum cardiotocography use in low-risk pregnancies and whether practice aligns with international and Danish national guidelines. Aim To describe the use and the initial indications of intrapartum cardiotocography in low-risk pregnancies. Furthermore, to investigate whether practice of intrapartum fetal monitoring aligns with international and Danish national guidelines. Methods A cross-sectional study was conducted among 411 women with low-risk pregnancies at a single hospital in Denmark. Data were retrieved from electronic medical records covering the period 1st January 2023 to 31st December 2023. Descriptive statistics were performed. Findings A total of 204 (49.6%) women with low-risk pregnancies were monitored with cardiotocography during labour. The most frequent initial indications for cardiotocography application were: fetal heart rate abnormalities ( n = 71, 34.8%), epidural analgesia administration ( n = 66, 32.4%), and meconium-stained amniotic fluid ( n = 34, 16.7%). In total, 35 cases (8.5%) did not align with the international guidelines, with the majority ( n = 23, 65.7%) receiving less extensive cardiotocography than recommended. In comparison, 57 cases (13.9%) did not align with the Danish national guidelines; among these, most women ( n = 54, 94.7%) received more extensive cardiotocography monitoring than recommended. Conclusion Approximately half of women with low-risk pregnancies were monitored with cardiotocography during labour. In general, intrapartum fetal monitoring practices in low-risk pregnancies showed minimal deviation from international and Danish national guidelines. Most of non-compliant cases were associated with epidural analgesia administration, highlighting an area that warrants increased attention in clinical practice.