Background
Controversy surrounds the role of fetal cardiotocography (CTG) in the antenatal management of pregnancy complicated with gestational diabetes mellitus (GDM).

Aim
The aim was to investigate whether antenatal CTG aids management in pregnancy complicated by GDM.

Materials and methods
A prospective audit of 1404 consecutive antenatal CTG in women diagnosed with GDM. Outcomes for all CTG were audited to determine whether CTG altered pregnancy management.

Results
In women requiring combination therapy (diet and medication), 43 CTG were required to change management of a pregnancy. In women managed by diet alone with a secondary pregnancy complication, 161 CTG were required to change management. In women managed by diet alone with no secondary pregnancy complication, CTG did not change management.

Conclusions
Antenatal CTG is not recommended in women with GDM managed by diet alone with no secondary pregnancy complication. Antenatal CTG is recommended in women with GDM who require combination therapy (diet and medication). The role of CTG in women managed by diet alone with a secondary pregnancy complication should be based upon the nature of the complication.