Abstract
Background: Fetal monitoring and interpretation of fetal well-being have evolved since their medical inception. The first to report a fetal heart was the mayor of Geneva in 1818. Stethoscopes were used to monitor the adult heart, and the first fetoscopy was performed in 1954. Cardiotocography (CTG) was created in the late 1960s to detect intrapartum hypoxia and detect abnormalities leading to distress. CTG guidelines for interpretation were published in 1979 and are widely used in many countries. However, overdiagnosis of fetal distress has led to litigation and misinterpretation. Fetal hypoxia can be identified using cardiotocography (CTG) during the intrapartum period, preventing long-term neurological effects. However, human factors, particularly midwives, can err in CTG interpretation. Studies show significant variation in interpretation, with 80% of fetal deaths occurring during the intrapartum period due to improper diagnosis. Healthcare providers, including midwives, must be trained to recognise and respond to abnormal CTG tracings. Regular evaluations of midwives' knowledge and skills are needed to improve fetal care.
Aim: The study assessed midwives' knowledge and understanding of CTG interpretation to enhance fetal heart monitoring quality during the intrapartum period.
Methods: The study utilised a non-interventional, retrospective, descriptive research design to assess midwives' knowledge of cardiotocography and compare their interpretations with the maternal care guidelines. Data were collected from 366 (n=366) files randomly selected from the population. The instrument used was modified from the CTG assessment of midwives in KZN.
Ethical principles of informed consent, privacy, and confidentiality were adhered to. A waiver of consent was submitted for ethical approval since the participants were files. The researcher kept the files anonymous, and the details were entered in the Excel spreadsheet for analysis. Data analysis included descriptive, inferential statistics. Once the data had been analysed, the researcher and the midwives reached agreement on CTG interpretation. The data analysis inferred midwives' knowledge in the CTG interpretation process.
Results: The findings showed that the researcher and the midwives did not agree on the interpretation of CTG, which led to the inference that midwives lacked knowledge
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of CTG interpretation. The study recommended training for midwives and policy derivation for CTG interpretation, which can address the interpretation of CTG and improve neonatal outcomes.