[Introduction of the S3 guideline "Vaginal Birth at Term" - What has changed in intrapartum fetal monitoring?]

Subpartum fetal monitoring is a debated topic in obstetrics. Studies have shown that CTG monitoring can lead to not always necessary interventions such as C-sections and vaginal-operative deliveries. Therefore, the 2021 AWMF S3 guideline "Vaginal Birth at Term" recommends structured intermittent auscultation instead of CTG monitoring in low-risk pregnancies for the first time.In a retrospective cross-sectional study, all German maternity clinics (n=616) were asked using an online questionnaire whether they use intermittent auscultation for low-risk pregnancies as well as reasons for and against it. The response rate was 16% (n=96). RESULTS:  22% (n=21) of clinics reported using intermittent auscultation always or sometimes. A significant correlation was found if changes had occurred and the application of intermittent auscultation (X2=12.95, df=2, p=0.001). Other factors such as the availability of one-to-one care (>95%), midwife-led delivery rooms, and differentiation between high- and low-risk pregnancies had no significant influence on the use of intermittent auscultation.The guideline has not led to the use of intermittent auscultation for monitoring in low-risk pregnancies. Clear low-risk definition, one-to-one care, qualified staff and updated studies on intermittent auscultation vs. CTG are needed.