A randomised controlled trial of admission electronic fetal monitoring in normal labour

Cheyne, Helen; Dunlop, Aileen; Shields, Noreen; Mathers, Alan

doi:10.1016/s0266-6138(03)00020-2

Cited by 28 publications

(33 citation statements)

References 12 publications

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“…In a previous study, midwives excluded 13% of the eligible population as they were subjectively judged to be too far advanced in labour or too distressed to give informed consent. 35 Recruitment and randomisation in labour have the advantage of higher yield and clinicians do routinely obtain consent during labour for a wide variety of necessary standard obstetric interventions, such as analgesia and caesarean section. 8,36 In the research setting, the investigator is required to explain the study rationale, risks, benefits and participant rights.…”

Section: Discussionmentioning

confidence: 99%

The ethics of obtaining consent in labour for research

Reid

Susic

Pathirana

et al. 2011

Australian and New Zealand Journal of Obstetrics and Gynaecology

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Section: Discussionmentioning

confidence: 99%

The ethics of obtaining consent in labour for research

Reid

Susic

Pathirana

et al. 2011

Australian and New Zealand Journal of Obstetrics and Gynaecology

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“…Categorisation of monitoring type for data collection purposes was based on the study reported by Cheyne and colleagues in 2003 [26] where continuous CTG was defined as use of the CTG machine for fetal heart monitoring for 75% or more of the labour. For this study, the category, electronic fetal monitoring (EFM), comprised all fetal heart monitoring performed with the CTG machine i.e.…”

Section: Methodsmentioning

confidence: 99%

Intelligent Structured Intermittent Auscultation (ISIA): evaluation of a decision-making framework for fetal heart monitoring of low-risk women

Maude

Skinner

Foureur

2014

BMC Pregnancy Childbirth

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BackgroundResearch-informed fetal monitoring guidelines recommend intermittent auscultation (IA) for fetal heart monitoring for low-risk women. However, the use of cardiotocography (CTG) continues to dominate many institutional maternity settings.MethodsA mixed methods intervention study with before and after measurement was undertaken in one secondary level health service to facilitate the implementation of an initiative to encourage the use of IA. The intervention initiative was a decision-making framework called Intelligent Structured Intermittent Auscultation (ISIA) introduced through an education session.ResultsFollowing the intervention, medical records review revealed an increase in the use of IA during labour represented by a relative change of 12%, with improved documentation of clinical findings from assessments, and a significant reduction in the risk of receiving an admission CTG (RR 0.75, 95% CI, 0.60 – 0.95, p = 0.016).ConclusionThe ISIA informed decision-making framework transformed the practice of IA and provided a mechanism for knowledge translation that enabled midwives to implement evidence-based fetal heart monitoring for low risk women.

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“…39 We considered women to be eligible for recruitment if they attended a participating maternity unit for assessment of labour and were primiparous, at term, and assessed as low risk on the basis of criteria used in previous intrapartum studies (box). [40][41][42] We used the same eligibility criteria in both experimental and control groups. In order to reduce confounding variables, we excluded multiparous women from the trial.…”

Section: Recruitment and Randomisationmentioning

confidence: 99%

Effects of algorithm for diagnosis of active labour: cluster randomised trial

Cheyne

Hundley

Dowding

et al. 2008

BMJ

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Objective To compare the effectiveness of an algorithm for diagnosis of active labour in primiparous women with standard care in terms of maternal and neonatal outcomes.Design Cluster randomised trial.Setting Maternity units in Scotland with at least 800 annual births.Participants 4503 women giving birth for the first time, in 14 maternity units. Seven experimental clusters collected data from a baseline sample of 1029 women and a post-implementation sample of 896 women. The seven control clusters had a baseline sample of 1291 women and a post-implementation sample of 1287 women.Intervention Use of an algorithm by midwives to assist their diagnosis of active labour, compared with standard care.Main outcomes Primary outcome: use of oxytocin for augmentation of labour. Secondary outcomes: medical interventions in labour, admission management, and birth outcome.Results No significant difference was found between groups in percentage use of oxytocin for augmentation of labour (experimental minus control, difference=0.3, 95% confidence interval −9.2 to 9.8; P=0.9) or in the use of medical interventions in labour. Women in the algorithm group were more likely to be discharged from the labour suite after their first labour assessment (difference=−19.2, −29.9 to −8.6; P=0.002) and to have more pre-labour admissions (0.29, 0.04 to 0.55; P=0.03).Conclusions Use of an algorithm to assist midwives with the diagnosis of active labour in primiparous women did not result in a reduction in oxytocin use or in medical intervention in spontaneous labour. Significantly more women in the experimental group were discharged home after their first labour ward assessment.Trial registration Current Controlled Trials ISRCTN00522952.

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A randomised controlled trial of admission electronic fetal monitoring in normal labour

Cited by 28 publications

References 12 publications

The ethics of obtaining consent in labour for research

The ethics of obtaining consent in labour for research

Intelligent Structured Intermittent Auscultation (ISIA): evaluation of a decision-making framework for fetal heart monitoring of low-risk women

Effects of algorithm for diagnosis of active labour: cluster randomised trial

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