Dr Penny Sheehan

speaker

716 appearances 5 recordings 1 series first heard Jun 2026 last heard 20 Jul

Dr Penny Sheehan’s voice in public audio — every appearance, attributed to the second.

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recordings per month · last 12 months

Recordings per month over the last 12 months — 5 in all, peaking in Jul 2026 with 3.

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Talking O&G - a RANZCOG Podcast · E21. Unpacking RANZCOG’s Intrapartum Fetal Surveillance Clinical Guideline (video) · 5 Jun 2026 podcast

And there's also the suggestion that for preterm you should use the fetus's CTG as its own benchmark.

So obviously a change in baseline or a change in the variability of the CTG could be considered significant.

Fetal sepsis is so significant because all neonatologists will tell you that for two neonates born at the same gestation, but one with sepsis and one without, the one with sepsis will definitely do worse.

So if you think that if you have any suspicion that the fetus is mounting an inflammatory response, you must expedite delivery.

And that's partly what the guideline says, to always consider sepsis, both maternal and fetal.

You know, expedite delivery if there's any suggestion that the fetus does have sepsis.

And of course, fetal blood sampling, scalp electrodes may be contraindicated.

Well, the fetal blood sampling is definitely contraindicated, but the scalp electrodes may also be contraindicated if, again, you suspect that sepsis is present.

Yeah, so the guideline, we spent quite a bit of time discussing tocolysis as well.

And prolonged decelerations over 90 seconds and up to five minutes can certainly be associated with fatal compromise and require action as listed in the guideline.

Excessive uterine activity is present, abnormal fetal heart rate patterns.

You can consider tocolytic therapy provided there are no contraindications and very important to consider always is are there any contraindications such as suspected abruption, suspected uterine rupture.

maternal medical conditions, allergies, fluid overload, any other reasons not to give tocolysis, of course, it shouldn't be used.

But it is definitely worth considering, especially in the presence of excessive uterine activity.

We couldn't make a recommendation on the safest drug.

The evidence is lacking.

So we think it's most important that a service puts together their own recommendation, settles on atocolitic and includes a guideline for that so that the whole team knows what to do and can easily access it.

Yeah, I thought it was really interesting to include this.

Thousands of years ago when I was a trainee, we used to do the vaginal examination and always look at the CTG through the VE and often comment afterwards, you know, oh, look, there was good excitation.

But it was never done in a kind of formalised way.

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