A controlled trial of the differential effects of intrapartum fetal monitoring

Haverkamp, Albert D.; Orleans, Miriam; Langendoerfer, Sharon; McFee, John; Murphy, James R.; Thompson, Howard E.

doi:10.1016/s0002-9378(16)33082-4

Cited by 363 publications

(128 citation statements)

References 19 publications

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“…The first randomized trial of EFM was published in 1979 (Haverkamp et al, 1979). That trial did not find any reduction in perinatal mortality or low Apgar scores but did report a marked increase in cesarean deliveries among women randomized to EFM.…”

Section: Intrapartum Carementioning

confidence: 99%

Fetal deaths in the United States, 1997 vs 1991

Yuan¹,

Platt

Morin

et al. 2005

American Journal of Obstetrics and Gynecology

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Section: Intrapartum Carementioning

confidence: 99%

Fetal deaths in the United States, 1997 vs 1991

Yuan¹,

Platt

Morin

et al. 2005

American Journal of Obstetrics and Gynecology

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“…In spite of this fact, the clinical benefit of electronic fetal monitoring is still controversial (4,11). The enormous rise of operative deliveries for fetal distress as the result of the introduction of continous fetal monitoring is the major objection of some authors against the general application of this technique (2,11). The indication of fetal distress in cases where actually no complication emerges is the major shortcoming of the CTG when used as the only technique of supervision (3) The complementary use of a biochemical parameter has been proposed as an adequate solution.…”

Section: Discussionmentioning

confidence: 99%

“…Fetal heart rate monitoring, which is used by the large majority of obstetricians, is of high value as a screening method as it has a high sensitivity but provides a number of false positive results (2,11). By indicating fetal distress which does not acutally exist, it leads to unnecessary operative deliveries, when used as the only method of fetal surveillance.…”

mentioning

confidence: 99%

Methodology and Clinical Value of Transcutaneous Blood Gas Measurements in the Fetus

Schmidt¹

1988

Jpme

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SummaryAiming at an improvement of fetal surveillance in high risk cases, a clinical trial was performed to evaluate the potential of fetal tcPco^ monitoring. An electrochemical tcPco 2 sensor heated at 44 ° C was applied in 119 fetuses after abnormal heart rate patterns had occured. The number of operative deliveries for fetal distress was reduced to 14 cases by means of the biochemical parameters (tcPco ~ )ar >d fetal blood analysis (FBA). In the majority of cases with pathologic heart rate patterns the tcPco 2 values were prepathologic or normal (60 %), while in 68 % of cases with prepathologic heart rate patterns the tcPco _ level was normal. At all instances an intrauterine complication was indicated by a marked rise of the tcPco2 level. The clinical benefit of using the tcPco measurement is the better specificity of detecting fetal distress when compared with the use of cardiotocography alone. Furthermore the tcPco technique has the advantage of providing continuous information about one biochemical parameter and of avoiding the necess ity of repeated incisions of the scalp, as compared with the technique of fetal blood analysis. In conclusion the use of this non-traumatic technique lends itself to avoid unnecessary operative deliveries in high risk cases.

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“…Experimental studies in humans [12][13][14] and in nonhuman primates 15 indicate that greater anxiety during labor can increase maternal or neonatal complications. There is no reason to assume that adverse outcomes would not be increased by detailed risk disclosure about intubation, tracheal suctioning, and severe MAS to most or all laboring women at $35 weeks' gestation.…”

Section: Comments By Dr Susan Wootton Dr Cody Arnold and Dr Jon Tysonmentioning

confidence: 99%

When Is Waiver of Consent Appropriate in a Neonatal Clinical Trial?

et al. 2014

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It is difficult to do scientifically rigorous research on treatments that must be administered urgently or emergently. Therefore, such treatments are often provided without a strong evidence base. Research would be facilitated if it were permissible to waive the requirement for parental consent. However, that raises a different set of concerns. Federal regulations allow waiver of the requirement for consent but only if studies meet certain conditions. Institutional review boards must decide whether those conditions are met. Sometimes, reasonable people disagree. We present and analyze a protocol for which investigators request a waiver of consent.

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A controlled trial of the differential effects of intrapartum fetal monitoring

Cited by 363 publications

References 19 publications

Fetal deaths in the United States, 1997 vs 1991

Fetal deaths in the United States, 1997 vs 1991

Methodology and Clinical Value of Transcutaneous Blood Gas Measurements in the Fetus

When Is Waiver of Consent Appropriate in a Neonatal Clinical Trial?

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