Can we make labour safer?
This WRH Research Group operates within our department’s Maternal & Fetal and Data Science themes; and is led by Antoniya Georgieva
Oxford Labour Monitoring
About the study
Oxford Labour Monitoring is committed to preventing the injury and death of babies during labour and delivery, caused by lack of oxygen in utero - uncommon but devastating events. Our work will potentially benefit families, clinicians and healthcare systems by reducing brain injuries, the deaths of babies during labour or after birth and unnecessary medical interventions in childbirth.
The Oxford Labour Monitoring group was established in 2022, building on its predecessor - Oxford Fetal Monitoring Technologies which began in early 2012 as a natural umbrella for the relevant work in the Nuffield Department of Women's & Reproductive Health spanning over 30 years.
We are developing data-driven cardiotocography (CTG) systems/software to continuously assess fetal wellbeing at the onset of and during term labour.
Why is this project important
During labour, uterine contractions reduce fetal oxygen supply. To cope, the fetus redirects blood to vital organs and adapts biochemically. Pre-existing issues like placental insufficiency, infections, or other pathophysiology can make it hard for the baby to compensate for these changes and the baby may experience permanent brain damage or even death from lack of oxygen.
In the UK, about half of labours are monitored with cardiotocography (CTG). Clinicians assess the CTG to identify signs of oxygen deprivation. If necessary, they can expedite delivery by Caesarean section or ventouse/forceps. However, CTG patterns are difficult to interpret and the physiology of fetal oxygenation alongside multiple risk factors is not well understood.
Video: Supporting Birth with the 'Fit4Labour' Decision Support Tool
Prof Antoniya Georgieva explains how the 'Fit4Labour' software tool could help better predict how well a particular baby will cope with the contractions during labour, leading to appropriate levels of intervention and safer births.
Improving Maternal and Fetal Health Outcomes
We are committed to improving outcomes for mothers and babies. We are doing research to understand which babies may sustain brain injury during labour and delivery due to lack of oxygen, and which births are uncomplicated and do not need an intervention.
As a result, our team of specialists from different disciplines has been developing clinical decision-support software, using information from over 100,000 pregnancies and births, including the baby’s heartbeat during labour, data about the mother’s and baby’s health and risk factors, along with information about the outcome at birth.
The risk-communication display is being co-developed iteratively at multiple hospitals. We continue to study the best ways to communicate risk in labour, aiming to ultimately underpin a ‘team’ approach to supported or shared decision making.
We want to give families the best start in life. Our innovative technology will help clinicians both better identify babies who are at risk of harm during labour and reduce unnecessary medical interventions.’
. - Prof. Antoniya Georgieva
How Our Decision-Support Tool Will Improve Clinical Practice
Our ultimate goal is to provide a robust and validated decision-support tool to be used by obstetricians and midwives as they monitor women and their babies using CTG during the early stages of labour. Having access to this tool will help clinicians assess the risks for babies in each labour in a more timely, individualised and precise manner, removing some of the current variability seen in the interpretation of CTG data
This should help clinicians identify sooner when babies are at risk of brain injury, meaning they can have conversations with families earlier around choices for interventions that could both limit harm and be life-saving.
Equally the tool can reduce unnecessary interventions in labours when it provides reassurance to clinicians that a baby is not at risk of immediate harm.
Public involvement
Oxford Labour Monitoring is committed to engaging the public in our work, by communicating what we do clearly and by putting the views and experiences of women and families at the centre of our research. Our Parent, Patient and Public Involvement (PPPI) strategy is publicly available and led by Rachel Plachchinski and Charlotte Bevan with the support of Nicky Lyon, founder of the Campaign for Safer Births and our PPPI Panel.
Read about the members of our PPPI Panel here.
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Charlotte Bevan
Parent, Patient and Public Involvement (PPPI) Expert
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Rachel Plachcinski
Parent, Patient and Public Involvement (PPPI) Co-Lead
Networking (SPaM Workshops)
The Signal Processing and Monitoring (SPaM) in Labour workshop is a bi-annual event and an exciting initiative aimed at bringing together experts in labor monitoring and fetal heart rate analysis. It provides a platform to critically review and discuss current issues such as new technologies, comprehensive digital databases, statistical analysis, classification, clinical practices, fetal physiology, and emerging challenges. Our team regularly attends and presents at these meetings.
Latest news
Visiting researcher and PHD student wins Best Poster award
Team member and research midwife Veronica Blanco Gutierrez's award-winning research - Intersectional Dynamics and Care Disparities in Intrapartum Electronic Fetal Monitoring: A socio-technical systems perspective, has been published in BMC Pregnancy and Childbirth. The study won best poster award at the British Intrapartum Conference last November.
Videos
Big data for fetal monitoring during labour: potential to improve outcomes
Big data for fetal monitoring during labour: potential to improve outcomes. Dr Antoniya Georgieva
SPaM workshop 2024
Antoniya Gergieva from the Oxford Labour Monitoring Group speaks at the Signal Processing and Monitoring (SPaM) in Labour workshop, July 2024, Cagliari, Italy,
SPaM workshop 2024
Mariana Tome from the Oxford Labour Monitoring Group speaks at the Signal Processing and Monitoring (SPaM) in Labour workshop, July 2024, Cagliari, Italy,
Latest Publications
- A deep learning method for locating fetal heart rate decelerations during labour using crowd-sourced data
- Trustworthy artificial intelligence and ethical design: public perceptions of trustworthiness of an AI-based decision-support tool in the context of intrapartum care
- Exploring the potential cost-effectiveness of a new computerised decision support tool for identifying fetal compromise during monitored term labours: an early health economic model
Principal Research Team
The research relating to monitoring during labour is led by Professor Antoniya Georgieva. Our specialist team develops data-driven cardiotocography (CTG) systems/software to continuously assess fetal wellbeing at the onset of and during term labour. We are based at the John Radcliffe Hospital and the Big Data Institute. The research is partially funded by the National Institute for Health Research (NIHR).
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Antoniya Georgieva
Associate Professor, Group Lead - Oxford Labour Monitoring
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Kristiyan Georgiev
Research Software Developer in Fetal Monitoring
Other members of the team
- Lawrence Impey, Oxford University Hospitals NHS Foundation Trust
- Xavier Laurent, Centre for Teaching and Learning, University of Oxford
- Veronica Blanco Gutierrez, University of Bristol
PPPI Group
- Ben Wills, Sands
- Sumayya Mulla, Happy MOMents
- Kathryn Kelly, National Childbirth Trust
- Nicky Lyon, co-founder, Campaign for Safer Births
Meet the members of our PPPI panel
Collaborators
- Austin Ugwumadu, St George's Hospital, London
- Hsu Chong, Birmingham Women's and Children's Hospital
- Ivan Jordanov, University of Portsmouth
- Health Economics team
- Health Innovation Oxford team
- Karolinska Instituet
How can you help?
You can support the ongoing work of the Oxford Labour Group project through donations, collaborations and research support. If you wish to support our work, please email Antoniya.Georgieva@wrk.ox.ac.uk