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May 29, 2026Sexual & Reproductive Healthcare0 citationsOpen Access

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

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FMFrederikke Brendstrup MadsenDGDitte GommesenNNNina Olsén Nathan

Key Result

Intrapartum cardiotocography was used in 49.6% of low-risk pregnancies during labour, showing minimal deviation from international (8.5%) and Danish national (13.9%) guidelines.

Key Points

  • This study aims to describe the use and indications of intrapartum cardiotocography in low-risk pregnancies and assess alignment with guidelines.
  • Cross-sectional study conducted among 411 women with low-risk pregnancies at a single hospital in Denmark.
  • Data retrieved from electronic medical records covering 2023.
  • Descriptive statistics were performed to analyze use and indications.
  • 204 women (49.6%) were monitored with cardiotocography during labor.
  • The main reasons for monitoring were fetal heart rate abnormalities (34.8%) and epidural analgesia (32.4%).
  • Non-compliance with guidelines occurred in 35 cases (8.5%) for international guidelines and 57 cases (13.9%) for Danish guidelines, mainly due to epidural analgesia.

Study Design

Type

Cross-Sectional (n=411)

Multicenter

No

Structured PICO

What is the extent of intrapartum cardiotocography use in low-risk pregnancies and does it align with guidelines?

P
Population
411 women with low-risk pregnancies at a single hospital in Denmark
I
Intervention
Intrapartum cardiotocography
O
Outcome
Use and initial indications of intrapartum cardiotocography, and alignment with international and Danish national guidelines

Approximately half of women with low-risk pregnancies receive intrapartum cardiotocography, generally aligning with guidelines, though deviations often relate to epidural analgesia.

Abstract

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.

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Cite This Study

Madsen et al. (2026) conducted a cross-sectional in Low-risk pregnancies (n=411). Intrapartum cardiotocography was evaluated on Use of intrapartum cardiotocography. Intrapartum cardiotocography was used in 49.6% of low-risk pregnancies during labour, showing minimal deviation from international (8.5%) and Danish national (13.9%) guidelines.

synapsesocial.com/papers/6a192cd5fab5b468c4415b0ahttps://doi.org/10.1016/j.srhc.2026.101236
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