A Prospective Comparison of Selective and Universal Electronic Fetal Monitoring in 34,995 Pregnancies

Leveno, Kenneth J.; Cunningham, F. Gary; Nelson, Sheryl; Roark, Micki; Williams, Monique; Guzick, David S.; Dowling, Sharon; Rosenfeld, Charles R.; BUCKLEY, ANN

doi:10.1097/00132586-198706000-00027

Cited by 21 publications

(31 citation statements)

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“…There is increasing emphasis on efficient use of technological fetal monitoring during labour. The developing consensus is that electronic monitoring may be best employed in a selected ‘high risk’ group (Leveno et al . 1986).…”

Section: Discussionmentioning

confidence: 99%

Measurement of amniotic fluid volume in early labour is a useful admission test

Teoh

Gleeson

Darling

1992

BJOG

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Section: Discussionmentioning

confidence: 99%

Measurement of amniotic fluid volume in early labour is a useful admission test

Teoh

Gleeson

Darling

1992

BJOG

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“…Leveno et a1 (18) in the largest randomized controlled trial to date investigating intrapartum fetal monitoring (34,995 women) found that in low-risk pregnancies intermittent auscultation performed 'at least' every 30 minutes resulted in perinatal outcomes similar to those obtained with electronic fetal monitoring. In this trial, labour requiring Syntocinon infusion was classified as 'high-risk' necessitating electronic monitoring.…”

Section: Discussionmentioning

confidence: 97%

Intermittent Auscultation for the Intrapartum Assessment of Fetal Well‐being in Western Australia

Gilles

Norman

Dawes

et al. 1997

Aust NZ J Obst Gynaeco

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In May 1995, in response to a decision of the Perinatal and Infant Mortality Committee of Western Australia, a survey of Western Australian hospitals was performed to ascertain what policies were in use for the monitoring of the fetal heart rate in labour and what proportion of these hospitals had access to electronic monitoring by cardiotocography. A response was received from 96% of the surveyed hospitals. More than half the births in this State (13,950 of 25,238) were monitored in labour using intermittent auscultation as the primary test; 7.5% of Western Australian births each year occurred in hospitals in which electronic monitoring was not available. Fewer than 50% of hospitals had written protocols describing the method of auscultation of the fetal heart during labour, the indications to contact a doctor or the management of fetal distress. The protocols which did exist displayed considerable variation in the recommended frequency of intermittent auscultation. The lack of standard practice in this field probably results from uncertainties in the literature. Intermittent auscultation has not been subjected to rigorous scientific evaluation as a screening tool and guidelines documenting ideal auscultatory practices need to balance the precision of electronic monitoring and freedom from intervention. Based on this compromise and existing evidence, a protocol for intermittent auscultation in normal labour is proposed.

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“…As foetal heart changes and acidosis occur in same frequency in high-risk as well as low-risk group during the course of labour. 6 Bearing the acute events during the course of labour, AT will be a good predictor of foetal wellbeing at the time of admission and during the next few hours of labour in term foetus. It will not predict the development of foetal distress that develops several hours later.…”

Section: Discussionmentioning

confidence: 99%

Role of Admission Test in Predicting Adverse Foetal Outcome

M¹

2016

jebmh

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BACKGROUND The aim of the evaluation of admission test in high-risk and low-risk groups. Evaluation of role of admission test in predicting adverse outcome of foetus in both low and high-risk groups'. MATERIALS AND METHODS This is a cross-sectional study done in Tirunelveli Medical College in a period of six months for 100 patients with equally divided low and high-risk groups. RESULTS With normal tracing, 96.9% of babies have no asphyxia. With suspicious trace, 65.2% had no asphyxia. With ominous trace, 58.3% had no asphyxia. In high-risk cases with normal tracings, 85% had no asphyxia. With suspicious tracing, 68.4% had no asphyxia. With ominous tracing, 54.5% had no asphyxia. In short, it is 78.6% sensitive in high-risk cases. In low-risk cases with normal tracing, 97.8% had no asphyxia. With suspicious tracing, 100% had no asphyxia. In short, AT is 91.8% specific in lowrisk cases. CONCLUSION Admission test is a good intrapartum test both in high-risk and low-risk groups. It is simple, highly acceptable and also it can be repeated. It has 78.6% sensitivity in high-risk cases, 91.8% specificity in low-risk cases and over all negative predictive value is 91%.

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A Prospective Comparison of Selective and Universal Electronic Fetal Monitoring in 34,995 Pregnancies

Cited by 21 publications

References 0 publications

Measurement of amniotic fluid volume in early labour is a useful admission test

Measurement of amniotic fluid volume in early labour is a useful admission test

Intermittent Auscultation for the Intrapartum Assessment of Fetal Well‐being in Western Australia

Role of Admission Test in Predicting Adverse Foetal Outcome

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