Caregivers' perspective on the implementation of continuous antepartum fetal monitoring in hospitalized high-risk pregnancies.

BACKGROUND

Continuous antepartum fetal monitoring has been proposed as an alternative to the current practice of intermittent monitoring of fetal well-being in high-risk pregnancies. Healthcare professionals, however, do not yet fully embrace the concept of continuous monitoring. In order to optimize implementation of continuous fetal monitoring, the current study investigates caregivers' opinions towards continuous fetal monitoring, devices to use, and the implementation in clinical care.

METHODS

This single center cross-sectional study was conducted at the Obstetric High Care unit of a tertiary referral center in the Netherlands, between July 2024 and October 2024. All caregivers working at the Obstetric High Care were sent a Dutch digital survey to measure caregivers' perspective of (1) antepartum continuous fetal monitoring, (2) two devices used in fetal monitoring, and (3) the implementation of continuous fetal monitoring on the Obstetric High Care.

RESULTS

Caregivers have an overall neutral opinion on the significance and impact of continuous fetal monitoring on obstetric management, maternal experience, and perinatal outcomes. They agree that, with greater knowledge of CTG characteristics in preterm fetuses, continuous fetal monitoring could enhance birth timing compared to intermittent monitoring. Preferences for CTG devices vary, influenced by factors such as ease of use, signal quality, and efficacy in monitoring obese women and preterm pregnancies.

CONCLUSIONS

Caregivers hold a neutral position on continuous fetal monitoring but recognize its potential with improved knowledge and technical optimization. Implementation strategies should focus on training, device usability, and addressing signal loss.