{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T12:01:59Z","timestamp":1792152119781,"version":"4.4.0"},"reference-count":51,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:00:00Z","timestamp":1760140800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2026,2]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Admission cardiotocography (CTG) remains widely used to assess the fetal condition at the onset of labour in low\u2010risk pregnancies, despite international guidelines recommending against its routine use and advocating intermittent auscultation (IA) instead.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate the effect of admission CTG compared with IA upon admission on maternal and neonatal outcomes in low\u2010risk term pregnancies.<\/jats:p>\n <\/jats:sec>\n \n Search Strategy<\/jats:title>\n PubMed and the Cochrane Library were searched from inception to April 2025.<\/jats:p>\n <\/jats:sec>\n \n Selection Criteria<\/jats:title>\n Randomised controlled trials (RCTs) comparing admission CTG with IA in low\u2010risk, term pregnancies with singleton fetuses.<\/jats:p>\n <\/jats:sec>\n \n Data Collection and Analysis<\/jats:title>\n Two reviewers independently screened studies, extracted data, and assessed risk of bias using RoB 2.0 from the Cochrane Library. Random\u2010effects meta\u2010analysis generated relative risks (RRs), and the quality of the evidence was evaluated using GRADE.<\/jats:p>\n <\/jats:sec>\n \n Main Results<\/jats:title>\n \n Five RCTs (16\u2009341 pregnant women) were included. Admission CTG was associated with significantly higher use of continuous electronic fetal heart rate (FHR) monitoring (RR 1.23, 95% CI: 1.05\u20131.44,\n I<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u200995%). No significant differences were found for caesarean section (RR 1.09, 95% CI: 0.86\u20131.37,\n I<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u200949%), fetal blood sampling (RR 1.16, 95% CI: 0.96\u20131.40,\n I<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u200944%), instrumental deliveries (RR 1.06, 95% CI: 0.90\u20131.19,\n I<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u200938%), neonatal intensive care unit (NICU) admission (RR 1.07, 95% CI: 0.91\u20131.27,\n I<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u20090%), or Apgar score <\u20097 at 5\u2009min (RR 0.97, 95% CI: 0.62\u20131.54,\n I<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u200913%). Evidence certainty was rated moderate for most outcomes.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Routine admission CTG in low\u2010risk term pregnancies demonstrated no improvement in maternal or neonatal outcomes. Previous concerns regarding increased caesarean delivery rates appear overstated. These findings support current recommendations favouring IA over routine admission CTG in low\u2010risk pregnancies. Future research should focus on intermediate\u2010risk populations, standardised implementation and clinically meaningful outcomes.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n PROSPERO registration number: CRD420251028693<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/1471-0528.70047","type":"journal-article","created":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:56:41Z","timestamp":1760169401000},"page":"375-390","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Revisiting the Value of Admission Cardiotocography in Term Pregnancies: An Updated Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1503-4161","authenticated-orcid":false,"given":"Mariana","family":"Tome","sequence":"first","affiliation":[{"name":"Oxford Labour Monitoring, Nuffield Department of Women's & Reproductive Health University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aim\u00e9e A. K.","family":"Lovers","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Amsterdam UMC Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4462-112X","authenticated-orcid":false,"given":"Lawrence","family":"Impey","sequence":"additional","affiliation":[{"name":"Oxford Labour Monitoring, Nuffield Department of Women's & Reproductive Health University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0176-2651","authenticated-orcid":false,"given":"Jane E.","family":"Hirst","sequence":"additional","affiliation":[{"name":"Oxford Labour Monitoring, Nuffield Department of Women's & Reproductive Health University of Oxford Oxford UK"},{"name":"The George Institute for Global Health, School of Public Health Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoniya","family":"Georgieva","sequence":"additional","affiliation":[{"name":"Oxford Labour Monitoring, Nuffield Department of Women's & Reproductive Health University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,11]]},"reference":[{"key":"e_1_2_11_2_1","article-title":"Cardiotocography Versus Intermittent Auscultation of Fetal Heart on Admission to Labour Ward for Assessment of Fetal Wellbeing","volume":"1","author":"Devane D.","year":"2017","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_11_3_1","volume-title":"Fetal Monitoring in Labour [NG229]","year":"2022"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2010.03.011"},{"issue":"1","key":"e_1_2_11_5_1","first-page":"16","article-title":"Fetal Heart Rate Monitoring in France: From Guidelines to Clinical Practice","volume":"37","author":"Carbonne B.","year":"2008","journal-title":"Journal de Gynecologie, Obstetrique et Biologie de la Reproduction"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2011.04.024"},{"key":"e_1_2_11_7_1","first-page":"57","article-title":"Implementation of the NICE Guideline Recommendations for Fetal Monitoring in Labour: A Survey of Hospital Practices in the Irish Republic","volume":"14","author":"Lutomski J. 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