True vs Spurious Intrapartum Fetal Heart Rate Accelerations on the Cardiotocograph (CTG): An Urgent Need for Caution

Transient increases in the fetal heart rate called “accelerations” on the cardiotocograph (CTG) trace during the intra partum period have been considered as ‘hallmarks’ of fetal wellbeing during labour. Several CTG guidelines have classified the fetal heart rate acceleration as a ‘reassuring feature”. The latest version of the Intra partum Fetal Heart Rate Monitoring Guidelines produced by the National Institute of Health and Care Excellence (NICE) in the UK states “the presence of fetal heart rate accelerations, even with reduced baseline variability, is generally a sign that the baby is healthy.