Optimising fetal growth monitoring in midwifery-led care: audit findings and women's experiences.

Background/Aims: Fetal growth assessment in midwifery-led care relies on symphysis–fundal height measurements, with deviations prompting ultrasound referral. Repeated scans, despite normal findings, can increase interventions and maternal anxiety. This project aimed to highlight if fewer growth scan...

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Publicado en:British Journal of Midwifery Vol. 34; no. 7; pp. 376 - 383
Autores principales: Baldock, Stephanie, Shawe, Jill
Formato: research tables/charts Journal Article
Publicado: Mark Allen Holdings Limited Jul2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul2026
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      pub: Mark Allen Holdings Limited
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        atl: Optimising fetal growth monitoring in midwifery-led care: audit findings and women's experiences.
      aug:
        au:
          Baldock, Stephanie
          Shawe, Jill
        affil: Pre-doctoral research fellow, Maternity Ultrasound, Torbay and South Devon NHS Trust
      sug:
        subj:
          Expectant Mothers Psychosocial Factors
          Fetal Monitoring Evaluation
          Fetal Development Evaluation
          Midwifery
          Midwives
          Ultrasonography, Prenatal
          Audit
          Patient Attitudes Evaluation
          Patient Satisfaction Evaluation
          Human
          Female
          Adolescence
          Adult
          Pilot Studies
          Multimethod Studies
          Retrospective Design
          Record Review
          Comparative Studies
          Descriptive Statistics
          Purposive Sample
          Semi-Structured Interview
          Questionnaires
          Data Analysis Software
          Thematic Analysis
          Pregnancy Trimester, Third
          Referral and Consultation
          Pregnancy
          Anxiety Psychosocial Factors
          Fetal Growth Retardation Diagnosis
          Fetal Growth Retardation Prevention and Control
          False Positive Results
          Early Diagnosis
          Funding Source
          Adolescent: 13-18 years
          Adult: 19-44 years
          Female
      ab: Background/Aims: Fetal growth assessment in midwifery-led care relies on symphysis–fundal height measurements, with deviations prompting ultrasound referral. Repeated scans, despite normal findings, can increase interventions and maternal anxiety. This project aimed to highlight if fewer growth scans could maintain safety, reduce unnecessary interventions and improve service efficiency. Methods: This mixed-methods study involved a 6-month retrospective audit of 204 growth charts of women referred for at least two growth scans at an NHS trust in southwest England, as well as patient and public involvement discussions with five women who had experienced the service. Quantitative audit data were analysed using descriptive statistics, while qualitative data from the discussions were analysed thematically. Results: Audit data showed that 45% of women had babies estimated to be in <10th centile by symphysis–fundal height, yet 85% of scans were normal and only 9% of babies were in <10th centile at birth. Almost half of women received conflicting referrals. Women reported that the process was confusing and stressful, supporting the need for improvement. Conclusions: Discrepancies between plotting methods led to additional scans. Clearer referral pathways and enhanced symphysis-fundal height training could reduce unnecessary scans and associated anxiety. Implications for practice: Changes to current protocol are needed to ensure care consistency in appropriate referrals. Training opportunities for midwives through mandatory study days and e-learning modules should promote continuity. An outside organisation could be consulted to develop a face-to-face training package for midwives.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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