Sökning: onr:"swepub:oai:gup.ub.gu.se/314884" >
Implementation of a...
Implementation of a revised classification for intrapartum fetal heart rate monitoring and association to birth outcome: A national cohort study
-
- Jonsson, Maria, 1966- (författare)
- Uppsala universitet,Klinisk obstetrik,Uppsala Univ Hosp, Uppsala, Sweden.
-
- Soderling, J. (författare)
- Karolinska Institutet
-
- Ladfors, Lars, 1951 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences,Gothenburg Univ, Sahlgrenska Acad, Inst Clin Sci, Gothenburg, Sweden.;Sahlgrens Univ Hosp, Gothenburg, Sweden.
-
visa fler...
-
- Nordstrom, L. (författare)
- Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden.
-
- Nilsson, M. (författare)
- Sahlgrens Univ Hosp, Gothenburg, Sweden.
-
- Algovik, M. (författare)
- Vastervik Hosp, Vastervik, Sweden.
-
- Norman, M. (författare)
- Karolinska Institutet
-
- Holzmann, M. (författare)
- Karolinska Institutet
-
visa färre...
-
(creator_code:org_t)
- 2022-01-28
- 2022
- Engelska.
-
Ingår i: Acta Obstetricia Et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 101:2, s. 183-192
- Relaterad länk:
-
http://uu.diva-porta...
-
visa fler...
-
https://doi.org/10.1...
-
https://uu.diva-port... (primary) (Raw object)
-
https://gup.ub.gu.se...
-
https://doi.org/10.1...
-
https://urn.kb.se/re...
-
http://kipublication...
-
visa färre...
Abstract
Ämnesord
Stäng
- Introduction A revised intrapartum cardiotocography (CTG) classification was introduced in Sweden in 2017. The aims of the revision were to adapt to the international guideline published in 2015 and to adjust the classification of CTG patterns to current evidence regarding intrapartum fetal physiology. This study aimed to investigate adverse neonatal outcomes before and after implementation of the revised CTG classification. Material and Methods A before-and-after design was used. Cohort I (n = 160 210) included births from June 1, 2014 through May 31, 2016 using the former CTG classification, and cohort II (n = 166 558) included births from June 1, 2018 through May 31, 2020 with the revised classification. Data were collected from the Swedish Pregnancy and Neonatal Registers. The primary outcome was moderate to severe neonatal hypoxic ischemic encephalopathy (HIE 2-3). Secondary outcomes were birth acidemia (umbilical artery pH <7.05 and base excess < -12 mmol/L or pH <7.00), A-criteria for neonatal hypothermia treatment, 5-min Apgar scores <4 and <7, neonatal seizures, meconium aspiration, neonatal mortality and delivery mode. Logistic regression was used (period II vs period I), and results are presented as adjusted odds ratios (aORs) with 95% confidence intervals (95% CIs). Results There were no statistically significant differences in HIE 2-3 (aOR 1.27; 95% CI 0.97-1.66), proportion of neonates meeting A-criteria for hypothermia treatment (aOR 0.96; 95% CI 0.89-1.04) or neonatal mortality (aOR 0.68; 95% CI 0.39-1.18) between the cohorts. Birth acidemia (aOR 1.36; 95% CI 1.25-1.48), 5-min Apgar scores <7 (aOR 1.27; 95% CI 1.18-1.36) and <4 (aOR 1.40; 95% CI 1.17-1.66) occurred more often in cohort II. The absolute risk difference for HIE 2-3 was 0.02% (95% CI 0.00-0.04). Operative delivery (vacuum or cesarean) rates were lower in cohort II (aOR 0.82; 95% CI 0.80-0.85 and aOR 0.94; 95% CI 0.91-0.97, respectively). Conclusions Although not statistically significant, a small increase in the incidence of HIE 2-3 after implementation of the revised CTG classification cannot be excluded. Operative deliveries were fewer but incidences of acidemia and low Apgar scores were higher in the latter cohort. This warrants further in-depth analyses before a full re-evaluation of the revised classification can be made.
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 acidemia
- fetal heart rate monitoring
- fetal
- hypoxia
- fetal monitoring
- fetal surveillance
- guideline
- hypoxic
- ischemic encephalopathy
- obstetric labor
- figo
- guidelines
- accuracy
- quality
- systems
- Obstetrics & Gynecology
- cardiotocography
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
Hitta via bibliotek
Till lärosätets databas
- Av författaren/redakt...
-
Jonsson, Maria, ...
-
Soderling, J.
-
Ladfors, Lars, 1 ...
-
Nordstrom, L.
-
Nilsson, M.
-
Algovik, M.
-
visa fler...
-
Norman, M.
-
Holzmann, M.
-
visa färre...
- Om ämnet
-
- MEDICIN OCH HÄLSOVETENSKAP
-
MEDICIN OCH HÄLS ...
-
och Klinisk medicin
-
och Reproduktionsmed ...
- Artiklar i publikationen
-
Acta Obstetricia ...
- Av lärosätet
-
Göteborgs universitet
-
Uppsala universitet
-
Karolinska Institutet