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Effectiveness of el...
Effectiveness of electronic fetal monitoring with additional ST analysis in vertex singleton pregnancies at > 36 weeks of gestation: an individual participant data metaanalysis
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Schuit, Ewoud (författare)
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- Amer-Wahlin, Isis (författare)
- Karolinska Institutet
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Ojala, Kati (författare)
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Vayssiere, Christophe (författare)
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Westerhuis, Michelle E. M. H. (författare)
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- Marsal, Karel (författare)
- Lund University,Lunds universitet,Obstetrik och gynekologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Obstetrics and Gynaecology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine
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Tekay, Aydin (författare)
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Saade, George R. (författare)
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Visser, Gerard H. A. (författare)
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Groenwold, Rolf H. H. (författare)
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Moons, Karel G. M. (författare)
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Mol, Ben Willem J. (författare)
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Kwee, Anneke (författare)
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(creator_code:org_t)
- Elsevier BV, 2013
- 2013
- Engelska.
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Ingår i: American Journal of Obstetrics and Gynecology. - : Elsevier BV. - 1097-6868 .- 0002-9378. ; 208:3, s. 1-187
- Relaterad länk:
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http://dx.doi.org/10...
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http://www.ajog.org/...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
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- OBJECTIVE: The purpose of this study was to assess the effectiveness of electronic fetal monitoring (EFM) alone and with additional ST analysis (EFM + ST) in laboring women with a singleton term pregnancy that is in cephalic presentation in the prevention of metabolic acidosis by the application of individual patient data metaanalysis. STUDY DESIGN: We conducted an individual patient data metaanalysis using data from 4 randomized trials, which enabled us to account for missing data and investigate relevant subgroups. The primary outcome was metabolic acidosis, which was defined as an umbilical cord-artery pH <7.05 and a base deficit that had been calculated in the extra cellular fluid compartment >12 mmol/L. We performed 8 explanatory subgroup analyses for 8 different endpoints. RESULTS: We analyzed data from 12,987 women and their newborn infants. Metabolic acidosis was present in 57 women (0.9%) in the EFM + ST group and 73 women (1.1%) in the EFM alone group (relative risk [RR], 0.76; 95% CI, 0.53-1.10). Compared with EFM alone, the use of EFM + ST resulted in a reduction in the frequency of instrumental vaginal deliveries (RR, 0.90; 95% CI, 0.83-0.99) and fetal blood samples (RR, 0.49; 95% CI, 0.44-0.55). Cesarean delivery rates were comparable between both groups (RR, 0.99; 95% CI, 0.91-1.09). Subgroup analyses showed that EFM + ST resulted in fewer admissions to a neonatal intensive care unit for women with a duration of pregnancy of >41 weeks (RR, 0.61; 95% CI, 0.39-0.95). CONCLUSION: EFM + ST does not reduce the risk of metabolic acidosis, but it does reduce the need for instrumental vaginal deliveries and fetal blood sampling.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)
Nyckelord
- cardiotocography
- fetal blood sampling
- fetal electrocardiogram
- instrumental vaginal delivery
- metabolic acidosis
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Schuit, Ewoud
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Amer-Wahlin, Isi ...
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Ojala, Kati
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Vayssiere, Chris ...
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Westerhuis, Mich ...
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Marsal, Karel
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visa fler...
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Tekay, Aydin
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Saade, George R.
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Visser, Gerard H ...
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Groenwold, Rolf ...
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Moons, Karel G. ...
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Mol, Ben Willem ...
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Kwee, Anneke
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