S1-Guideline on the Use of CTG During Pregnancy and Labor

Abstract

The aim of this consensus paper is to standardize the use of cardiotocograms (CTG) in fetal monitoring using an evidence-based approach. Recommended standards take the impact of disturbances and other influencing variables on the CTG into account, use standard definitions and objective assessment methods, and look at upstream diagnostic procedures and adjunct monitoring methods. The target audience for this consensus paper are all professionals who use CTG readings to monitor pregnancies and childbirth, most notably gynecologists and midwives. Method: This guideline was compiled with particular reference to and in consideration of previous recommendations [85], the FIGO guidelines [59, 82], and the guidelines of the Royal College of Obstetricians and Gynaecologists [84], the NICHD [72], the Society of Obstetrics and Gynecologists Canada [110] and the American College of Obstetricians and Gynecologists [4, 5] as well as evidence-based data, where available. The basis for this guideline is the best available "evidence" which was carefully collected and classified by the members of the consensus group. It was not possible in every case to compile recommendations directly from the evidence level provided in the available literature. The recommendations show what is generally considered good clinical practice, so far as this was not queried by the persons involved in the consensus process. With regard to the requirements speci

Contribution of proactive management of healthcare risks to the reduction of adverse events in a maternity hospital

“…Aware of their weaknesses and the actions that are possible or not to implement, the multidisciplinary team understood that the main bottleneck in caring for pregnant women would lie in fetal well-being, especially in standardising the performance and analysis of cardiotocography, which is supported by the literature. 37 38 Therefore, it was understood that initially unifying the report and finally creating a structure to ensure adherence to a periodicity of performing and analysing tests was necessary. This led to the adoption of the WHO classification for cardiotocography exams, the mandatory and biennial development of e-learning on the exam, and the creation of an alert system for exceeding the time interval between exams, connected to the hospital’s monitoring centre.…”

Is Unfavourable Cervix prior to Labor Induction Risk for Adverse Obstetrical Outcome in Time of Universal Ripening Agents Usage? Single Center Retrospective Observational Study

“…The question that remains unresolved is the following: “did the better outcomes of cord blood acid-base balance result from a higher percentage of surgical deliveries?” The nature of this work does not allow to answer such a question. At the same time, one should remember that the cardiotocographic record has false positive (false pathological) changes in up to 50% [ 19 ], and seemingly, pathological changes for the person supervising the delivery may in fact be physiological changes in the fetus' heart rate. All deliveries in the study were subject to continuous CTG monitoring, because induced deliveries are not physiological in the meaning of Polish law [ 20 ].…”

Kritisches Outcome und Hypoxisch-Ischämische Enzephalopathie (HIE) – Ein Thema der Qualitätssicherung

“…Measures of external quality assurance should integrate the analysis of both perinatal and neonatal surveys as a basis for quality management (QM). keit vom Ergebnis der Evaluation als N = normal, S = suspekt und P = pathologisch überprüft, ob die Durchführung der angezeigten konservativen, respektive operativen Maßnahmen dokumentiert war [11,12]. Weiterhin wurde das Geburtsprotokoll für besondere klinische Befunde (z.…”