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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Fältnamn	Indikatorer	Metadata
000		04286naa a2200529 4500
001		oai:lup.lub.lu.se:1703824c-1a30-4c45-8890-7c6d612e6c0d
003		SwePub
008		160401s2013 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
009		oai:prod.swepub.kib.ki.se:126211641
024	7	a https://lup.lub.lu.se/record/36714542 URI
024	7	a https://doi.org/10.1016/j.ajog.2013.01.0282 DOI
024	7	a http://kipublications.ki.se/Default.aspx?queryparsed=id:1262116412 URI
040		a (SwePub)lud (SwePub)ki
041		a engb eng
042		9 SwePub
072	7	a art2 swepub-publicationtype
072	7	a ref2 swepub-contenttype
100	1	a Schuit, Ewoud4 aut
245	1 0	a Effectiveness of electronic fetal monitoring with additional ST analysis in vertex singleton pregnancies at > 36 weeks of gestation: an individual participant data metaanalysis
264	1	b Elsevier BV,c 2013
520		a 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.
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Reproduktionsmedicin och gynekologi0 (SwePub)302202 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Obstetrics, Gynaecology and Reproductive Medicine0 (SwePub)302202 hsv//eng
653		a cardiotocography
653		a fetal blood sampling
653		a fetal electrocardiogram
653		a instrumental vaginal delivery
653		a metabolic acidosis
700	1	a Amer-Wahlin, Isisu Karolinska Institutet4 aut
700	1	a Ojala, Kati4 aut
700	1	a Vayssiere, Christophe4 aut
700	1	a Westerhuis, Michelle E. M. H.4 aut
700	1	a Marsal, Karelu 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 Medicine4 aut0 (Swepub:lu)gyn-kma
700	1	a Tekay, Aydin4 aut
700	1	a Saade, George R.4 aut
700	1	a Visser, Gerard H. A.4 aut
700	1	a Groenwold, Rolf H. H.4 aut
700	1	a Moons, Karel G. M.4 aut
700	1	a Mol, Ben Willem J.4 aut
700	1	a Kwee, Anneke4 aut
710	2	a Karolinska Institutetb Obstetrik och gynekologi, Lund4 org
773	0	t American Journal of Obstetrics and Gynecologyd : Elsevier BVg 208:3, s. 1-187q 208:3<1-187x 1097-6868x 0002-9378
856	4	u http://dx.doi.org/10.1016/j.ajog.2013.01.028y FULLTEXT
856	4	u http://www.ajog.org/article/S0002937813000756/pdf
856	4 8	u https://lup.lub.lu.se/record/3671454
856	4 8	u https://doi.org/10.1016/j.ajog.2013.01.028
856	4 8	u http://kipublications.ki.se/Default.aspx?queryparsed=id:126211641

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Av författaren/redakt...: Schuit, Ewoud; Amer-Wahlin, Isi ...; Ojala, Kati; Vayssiere, Chris ...; Westerhuis, Mich ...; Marsal, Karel; visa fler...; Tekay, Aydin; Saade, George R.; Visser, Gerard H ...; Groenwold, Rolf ...; Moons, Karel G. ...; Mol, Ben Willem ...; Kwee, Anneke; visa färre...

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