Recurrent DFM with an abnormal CTG — communication and decision station

Communication-and-decision station: recurrent DFM with an abnormal CTG and suspected fetal growth restriction. Tests the candidate's ability to escalate to a senior, make a defensible decision to expedite birth, and communicate sensitively with a frightened woman. Includes assessor key and marking domains.

Prompt

A 33-year-old G2P1 smoker at 37 weeks presents for the second time in eight days reporting reduced fetal movements. Her CTG today shows reduced variability and recurrent late decelerations, and her fundal height is 34 cm. You are the registrar with the consultant on the phone. The woman is frightened and asking whether she will lose her baby.

Station brief

Format. Communication and decision station, approximately 12 minutes. You are the obstetric registrar on the antenatal ward. The consultant is available by phone. A midwife and the woman's partner are present. The assessor will run the clock and feed new information. ^[2]

Candidate instruction. Take a focused history, run the assessment, escalate to your consultant, make a defensible decision about birth, and communicate sensitively with the woman and her partner. Verbalise your reasoning out loud. ^[2]^[3]

References5Show

[1]Thompson JMD, Wilson J, Bradford BF, et al. A better understanding of the association between maternal perception of foetal movements and late stillbirth: findings from an individual participant data meta-analysis BMC Med, 2021.PMID 34775977
[2]Lu Y, Palin V, Heazell A Risk factors for adverse pregnancy outcomes in reduced fetal movement: an IPD meta-analysis BJOG, 2025.PMID 40091517
[3]Dutton PJ, Warrander LK, Roberts SA, et al. Predictors of poor perinatal outcome following maternal perception of reduced fetal movements: a prospective cohort study PLoS One, 2012.PMID 22808059
[4]Butler E, Hugh O, Gardosi J Evaluating the Growth Assessment Protocol for stillbirth prevention: progress and challenges J Perinat Med, 2022.PMID 35618671
[5]Andrews C, Boyle FM, Pade A, et al. Experiences of antenatal care practices to reduce stillbirth: surveys of women and healthcare professionals pre-post implementation of the Safer Baby Bundle BMC Pregnancy Childbirth, 2024.PMID 39090562

Recurrent DFM with an abnormal CTG — communication and decision station

Station brief

References5Show

[1]Thompson JMD, Wilson J, Bradford BF, et al. A better understanding of the association between maternal perception of foetal movements and late stillbirth: findings from an individual participant data meta-analysis BMC Med, 2021.PMID 34775977
[2]Lu Y, Palin V, Heazell A Risk factors for adverse pregnancy outcomes in reduced fetal movement: an IPD meta-analysis BJOG, 2025.PMID 40091517
[3]Dutton PJ, Warrander LK, Roberts SA, et al. Predictors of poor perinatal outcome following maternal perception of reduced fetal movements: a prospective cohort study PLoS One, 2012.PMID 22808059
[4]Butler E, Hugh O, Gardosi J Evaluating the Growth Assessment Protocol for stillbirth prevention: progress and challenges J Perinat Med, 2022.PMID 35618671
[5]Andrews C, Boyle FM, Pade A, et al. Experiences of antenatal care practices to reduce stillbirth: surveys of women and healthcare professionals pre-post implementation of the Safer Baby Bundle BMC Pregnancy Childbirth, 2024.PMID 39090562