Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/88501
Citations | ||
Scopus | Web of Science® | Altmetric |
---|---|---|
?
|
?
|
Type: | Journal article |
Title: | Cardiotocography plus ST analysis of fetal electrocardiogram compared with cardiotocography only for intrapartum monitoring: a randomized controlled trial |
Author: | Westerhuis, M. Visser, G. Moons, K. van Beek, E. Benders, M. Bijvoet, S. van Dessel, H. Drogtrop, A. van Geijn, H. Graziosi, G. Groenendaal, F. van Lith, J. Nijhuis, J. Oei, S. Oosterbaan, H. Porath, M. Rijnders, R. Schuitemaker, N. Sopacua, L. van der Tweel, I. et al. |
Citation: | Obstetrics and Gynecology, 2010; 115(6):1173-1180 |
Publisher: | Lippincott Williams & Wilkins |
Issue Date: | 2010 |
ISSN: | 0029-7844 1873-233X |
Statement of Responsibility: | Michelle E. M. H. Westerhuis, Gerard H. A. Visser, Karel G. M. Moons, Erik van Beek, Manon J. Benders, Saskia M. Bijvoet, Hendrikus J. H. M. van Dessel, Addy P. Drogtrop, Herman P. van Geijn, Giuseppe C. Graziosi, Floris Groenendaal, Jan M. M. van Lith, Jan G. Nijhuis, S. Guid Oei, Herman P. Oosterbaan, Martina M. Porath, Robbert J. P. Rijnders, Nico W. E. Schuitemaker, Louisa M. Sopacua, Ingeborg van der Tweel, Lia D. E. Wijnberger, Christine Willekes, Nicolaas P. A. Zuithoff, Ben Willem J. Mol, and Anneke Kwee |
Abstract: | OBJECTIVE: To estimate the effectiveness of intrapartum fetal monitoring by cardiotocography plus ST analysis using a strict protocol for performance of fetal blood sampling. METHODS: We performed a multicenter randomized trial among laboring women with a high-risk singleton pregnancy in cephalic presentation beyond 36 weeks of gestation. Participants were assigned to monitoring by cardiotocography with ST analysis (index) or cardiotocography only (control). Primary outcome was metabolic acidosis, defined as an umbilical cord artery pH below 7.05 combined with a base deficit calculated in the extracellular fluid compartment above 12 mmol/L. Secondary outcomes were metabolic acidosis in blood, operative deliveries, Apgar scores, neonatal admissions, and hypoxic–ischemic encephalopathy. RESULTS: We randomly assigned 5,681 women to the two groups (2,832 index, 2,849 control). The fetal blood sampling rate was 10.6% in the index compared with 20.4% in the control group (relative risk 0.52; 95% [CI] 0.46–0.59). The primary outcome occurred 0.7% in the index compared with 1.1% in the control group (relative risk 0.70; 95% CI 0.38–1.28; number needed to treat 252). Using metabolic acidosis calculated in blood, these rates were 1.6% and 2.6%, respectively (relative risk 0.63; 95% CI 0.42–0.94; number needed to treat 100). The number of operative deliveries, low Apgar scores, neonatal admissions, and newborns with hypoxic–ischemic encephalopathy was comparable in both groups. CONCLUSION: Intrapartum monitoring by cardiotocography combined with ST analysis does not significantly reduce the incidence of metabolic acidosis calculated in the extracellular fluid compartment. It does reduce the incidence of metabolic acidosis calculated in blood and the need for fetal blood sampling without affecting the Apgar score, neonatal admissions, hypoxic–ischemic encephalopathy, or operative deliveries. CLINICAL TRIAL REGISTRATION: ISRCTN Register, www.isrctn.org, ISRCTN95732366. LEVEL OF EVIDENCE: I |
Keywords: | Humans Hypoxia-Ischemia, Brain Acidosis Cardiotocography Electrocardiography Pregnancy Adult Infant, Newborn Female |
Rights: | © 2010 by The American College of Obstetricians and Gynecologists. |
DOI: | 10.1097/AOG.0b013e3181dfffd6 |
Published version: | http://dx.doi.org/10.1097/aog.0b013e3181dfffd6 |
Appears in Collections: | Aurora harvest 7 Paediatrics publications |
Files in This Item:
There are no files associated with this item.
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.