# Midwives’ cardiotocograph interpretation and documentation knowledge in a selected Gauteng hospital

## TL;DR

This study found that midwives in a Gauteng hospital often failed to properly document and interpret cardiotocograph (CTG) readings, which could impact the quality of care during childbirth.

## Contribution

The study highlights significant gaps in midwives' CTG documentation and interpretation practices in a South African hospital setting.

## Key findings

- Midwives showed gaps in CTG documentation ranging from 31% to 100% across five criteria.
- Researchers maintained complete CTG records, while midwives had significant omissions.
- Poor documentation may affect intrapartum care quality and clinical decision-making.

## Abstract

Cardiotocography (CTG) is a globally used intrapartum monitoring tool to assess the foetal heart rate and the related responses to the physiology of the uterine action. The intrapartum foetal monitoring is the primary responsibility of the midwives caring for the woman in labour. Midwives’ knowledge and understanding of CTG traces and interpretation ensure timely responses to pathological findings, thus ensuring positive foetal and neonatal outcomes.

The study aimed to assess the midwives’ knowledge of cardiotocograph interpretation and documentation in a selected hospital in Gauteng.

The data were collected in a selected secondary hospital, a referral hospital for the midwife-led obstetric units and district hospitals in the Gauteng province.

The study employed a quantitative retrospective research design, utilising a checklist to analyse patients’ past medical records – this retrospective analysis aimed to evaluate midwives’ knowledge in interpreting CTG.

A review of 336 CTG case records analysed five criteria: baseline heart rate, variability, decelerations, accelerations, and overall trace assessment. Significant discrepancies in record-keeping were found between midwives and researchers. Researchers maintained complete records and interpretations for all criteria, whereas midwives exhibited considerable gaps, ranging from 31% to 100% across the CTG criteria.

Analysis indicates a substantial gap in CTG documentation by midwives compared to researchers.

Midwives exhibiting significant data omissions that may affect intrapartum care quality and clinical decisions.