Fetal scalp stimulation (FSS) versus fetal blood sampling (FBS) for women with abnormal fetal heart rate monitoring in labor: a prospective cohort study

Mahmood, Uzma; O’Gorman, Catherine; Marchocki, Zibi; O’Brien, Yvonne M.; Murphy, Deirdre J

doi:10.1080/14767058.2017.1326900

Cited by 12 publications

(10 citation statements)

References 17 publications

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“…Our results differ significantly from most of the published results inclusively the meta-analysis but are very similar to the results found in the study by Holzman et al [3,7,18,19]. One explanation could be measurements of pH rather than lactate as in Holzmann's and our study.…”

Section: Discussionsupporting

confidence: 87%

Effectiveness of fetal scalp stimulation test in assessing fetal wellbeing during labor, a retrospective cohort study

Shakouri¹,

Iorizzo

Edwards

et al. 2020

BMC Pregnancy Childbirth

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Background: It is discussed whether fetal scalp stimulation (FSS) test is a reliable complimentary tool to cardiotocography (CTG) to assess fetal wellbeing during labor. The test is based on the assumption that a welloxygenated fetus, in contrast to the depressed fetus, will respond to a certain stimulus. The aim of this study was to investigate the effectiveness of the FSS-test. Methods: A retrospective observational study carried out

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Section: Discussionsupporting

confidence: 87%

Effectiveness of fetal scalp stimulation test in assessing fetal wellbeing during labor, a retrospective cohort study

Shakouri¹,

Iorizzo

Edwards

et al. 2020

BMC Pregnancy Childbirth

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“…Jedoch sprechen die Ergebnisse von 2 Studien 13 18 sowie eine Metaanalyse 21 eher für die Aussagekraft von FSS, während 3 weitere Studien die FSS als aussagekräftig einstufen 8 9 22 . Daher lässt sich grundsätzlich feststellen, dass, obwohl die Datenlage nicht homogen ist, die identifizierte Literatur eher für die Anwendung beziehungsweise den Nutzen von FSS als Second Line Test spricht.…”

Section: Ergebniszusammenfassung Eines Integrativen Literaturreviews ...unclassified

“…Auch das Evidenzlevel, welches anhand OCEBM 12 ermittelt wurde, liegt bei 6 von 8 Studien nur bei Level III von V (siehe Abb. 3 ) 8 9 11 18 19 22 . Die inkludierte Metaanalyse von Skupski et al 21 wurde mithilfe eines weiteren Analyseinstrumentes, AMSTAR 2 20 , aufgrund des nicht ausreichend berücksichtigten Risk of Bias als sehr niedrig bezüglich ihrer Qualität beurteilt.…”

Section: Ergebniszusammenfassung Eines Integrativen Literaturreviews ...unclassified

“…Bereits in den 1980er Jahren wurden eine Reihe von Studien mit ersten Nachweisen für den Nutzen der Stimula tion der fetalen Kopfhaut während einer vaginalen Untersuchung als Zusatzkriterium bei Auffälligkei-ten der fetalen Herzfrequenz publiziert [3,5,6]. Aktuelle Studien zur FSS liefern Ergebnisse, die für eine Anwendung dieser Methode sprechen -auch im direkten Vergleich mit der Mikroblutuntersuchung [8,13,22].…”

Section: Fetal Scalp Stimulationunclassified

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Reine Kopfsache: Fetal Scalp Stimulation zur Bestimmung der fetalen Vitalität während der Geburt

Stützel¹,

Rametsteiner²

2023

Hebamme

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“…We conducted a prospective cohort study of 299 consecutive second-line tests comparing FBS and FSS [ 13 ]. There was a strong correlation between the FBS and FSS results suggesting that in most cases the FSS test would be as reliable as FBS.…”

Section: Background and Rationale {6a}mentioning

confidence: 99%

Digital fetal scalp stimulation (dFSS) versus fetal blood sampling (FBS) to assess fetal wellbeing in labour—a multi-centre randomised controlled trial: Fetal Intrapartum Randomised Scalp Stimulation Trial (FIRSST NCT05306756)

Murphy

Shahabuddin

Yambasu

et al. 2022

Trials

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Background Cardiotocography (CTG) is a screening test used to detect fetal hypoxia in labour. It has a high false positive rate resulting in many potentially unnecessary caesarean sections. Fetal blood sampling (FBS) is a second-line test of the acid-base status of the fetus. It is used to provide either reassurance that it is safe for labour to continue or objective evidence of compromise so that delivery can be expedited. Digital fetal scalp stimulation (dFSS) to elicit a fetal heart rate acceleration is an alternative less invasive second-line test of fetal wellbeing. This study aims to provide robust evidence on the role of these two second-line tests in assessing fetal wellbeing and potentially preventing operative delivery. Methods A multi-centre parallel group randomised controlled trial (RCT) is planned in four maternity centres in Ireland. The study aims to recruit 2500 nulliparous women with a term (≥37+0 weeks) singleton pregnancy who require a second-line test of fetal wellbeing in labour due to an abnormal CTG. Women will be allocated randomly to dFSS or FBS on a 1:1 ratio. The primary outcome is caesarean section. With 1250 women in each arm, the study will have 90% power to detect a difference of 5–6%, at a two-sided alpha significance level of 5%, assuming a caesarean section rate of at least 20% in the dFSS group. Discussion If the proposed study shows evidence that dFSS is a safe, reliable and effective alternative to FBS, this would have ground-breaking implications for labour management worldwide. It could potentially lead to a reduction in invasive procedures and emergency caesarean sections. Trial registration ClinicalTrials.gov NCT05306756. Registered on 31 March 2022. The trial commenced enrolment on 10 May 2022. Ethical committee approval has been granted by the Research Ethics Committee (REC) of each hospital: Dublin/CWIUH REC: 12.06.2019; Cork/UCC REC: 29.11.2019; Galway/NUIG REC: 06.09.2019; Limerick/UL REC: 30.09.2019.

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Fetal scalp stimulation (FSS) versus fetal blood sampling (FBS) for women with abnormal fetal heart rate monitoring in labor: a prospective cohort study

Abstract: This study suggests that FSS has the potential to be a reliable alternative to FBS. The findings require evaluation in a well-designed randomized controlled trial.

Cited by 12 publications

References 17 publications

Effectiveness of fetal scalp stimulation test in assessing fetal wellbeing during labor, a retrospective cohort study

Effectiveness of fetal scalp stimulation test in assessing fetal wellbeing during labor, a retrospective cohort study

Reine Kopfsache: Fetal Scalp Stimulation zur Bestimmung der fetalen Vitalität während der Geburt

Digital fetal scalp stimulation (dFSS) versus fetal blood sampling (FBS) to assess fetal wellbeing in labour—a multi-centre randomised controlled trial: Fetal Intrapartum Randomised Scalp Stimulation Trial (FIRSST NCT05306756)

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