As I sit down to write this article, I am very much aware that today is the anniversary of the death of my mother. A strong-minded, intelligent and, above all, proud woman, her greatest fear as she became increasingly physically frail was a loss of dignity, something she had witnessed in the slow demise of her own mother.
From middle age onwards, she wrote me detailed letters describing what she would and would not tolerate as she got older, and instructing me, the only doctor in the family, to do everything possible to help her to die peacefully when the intolerable became manifest. Sadly, the law forbade such measures and, despite receiving excellent care in her failing years, she suffered much of the indignity that she most feared before passing.
Cardiotocography (CTG) to monitor foetal heart rate is frequently used on the labour ward to monitor for foetal distress. Interpretation of CTG is routinely undertaken by the obstetric and midwifery teams to guide labour interventions, along with the mode and urgency of delivery. Anaesthetists are a key member of the multidisciplinary team, and we should therefore understand CTG. This knowledge can then help with joint decision-making, provide an additional set of eyes observing for foetal distress, and be an aid for choosing an anaesthetic technique.
The 2021 curriculum mentions CTG knowledge in both Stage 1 and in the Obstetric Anaesthesia Specialist Interest area.1 However, there is a lack of clarity on how to obtain it. Despite there being excellent resources available for anaesthetists to learn about CTG interpretation, it is not formally taught or assessed.2 It is left to the individual anaesthetist in training to obtain this knowledge, creating a lack of consistency in knowledge among anaesthetists.
