Does knowledge of fetal outcome influence the interpretation of intrapartum cardiotocography and subsequent clinical management? A multicentre European study

Reif, P; Schott, Sarah; Boyon, Charlotte; Richter, Jute; Kavšek, Gorazd; Timoh, Krystel Nyangoh; Haas, Josef; Pateisky, Petra; Griesbacher, Antonia; Lang, Uwe; Ayres-de-Campos, Diogo

doi:10.1111/1471-0528.13882

Cited by 28 publications

(24 citation statements)

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“…The interpreters in the study were blinded to outcome, which is necessary to avoid ascertainment bias [ 25 , 26 ]. In the clinical management of labor, CTG is just one part of the management, but since our purpose was to assess the CTG templates as such, and not clinical management, we considered it proper to leave the interpreters blind for clinical data, minimizing the risk of bias.…”

Section: Discussionmentioning

confidence: 99%

Low sensitivity of the new FIGO classification system for electronic fetal monitoring to identify fetal acidosis in the second stage of labor

Ekengård

Cardell

Herbst

2021

European Journal of Obstetrics & Gynecology and Reproductiv

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Section: Discussionmentioning

confidence: 99%

Low sensitivity of the new FIGO classification system for electronic fetal monitoring to identify fetal acidosis in the second stage of labor

Ekengård

Cardell

Herbst

2021

European Journal of Obstetrics & Gynecology and Reproductiv

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“…Whether permanent fetal monitoring via CTG causes fetal harm has not been investigated yet, but experts in ultrasound medicine recommend following the as low as reasonably achievable principle for the use of ultrasound in obstetrics [26,27]. Finally, the reading of CTGs has a high intra- and interrater variability [28]. These results fueled the development of computer-based CTG analysis [29] to increase the reliability of CTG interpretation in the future.…”

Section: Discussionmentioning

confidence: 99%

Women’s Attitudes Toward Self-Monitoring of Their Pregnancy Using Noninvasive Electronic Devices: Cross-Sectional Multicenter Study

Schramm¹,

Graßl²,

Nees³

et al. 2019

JMIR Mhealth Uhealth

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BackgroundPregnancy can be distressing, particularly if expectant mothers are worried about the well-being of their fetus. Consequently, the desire for reassurance and frequent fetal monitoring is often pronounced. Smart wearable devices and telemedicine are promising tools that could assist women in self-monitoring their pregnancy at home, hence disburdening emergency departments (EDs). They present the possibility to clarify the need for urgent care remotely and offer tighter pregnancy monitoring. However, patients’ acceptance of such new technologies for fetal monitoring has not yet been explored extensively.ObjectiveThis survey aimed to elucidate the attitudes of women toward self-monitoring of their pregnancy using noninvasive electronic devices. The technical details of the proposed devices were not specified.MethodsA cross-sectional multicenter study was conducted at the departments of obstetrics of the University Hospitals of Heidelberg and Leipzig, Germany. All patients seen in the obstetrics clinic who were above 18 years were offered participation. We designed a survey questionnaire including validated instruments covering population characteristics, issues in current and past pregnancies, as well as attitudes toward self-monitoring of pregnancy with smart devices.ResultsA total of 509 pregnant women with no previous experience in telemedicine participated. Only a small minority of 5.9% (29/493) regarded self-monitoring with wearable devices as an alternative to consulting their physicians. Along these lines, only 7.7% (38/496) strongly believed they would visit the ED less often if such devices were readily available. However, if the procedure were combined with a Web-based telemetric physician consult, 13.5% (66/487) would be highly motivated to use the devices. Furthermore, significantly more women regarded it as an alternative prior to seeing a doctor when they perceived a decline in fetal movements (P<.001). Interestingly, women with university degrees had a higher propensity to engage in pregnancy self-monitoring compared with women without one (37% vs 23%; P=.001). Of the participants, 77.9% (381/489) would like smart wearable devices to measure fetal heart sounds, and 62.6% (306/489) wished to use the devices on their own. Feedback from a doctor or midwife was also very important in their choice of such devices (61.8%, 301/487 wished feedback). The intended frequency of use differed vastly among women, ranging from 13.8% (65/471) who would like to use such a device several times per day to 31.6% (149/471) who favored once per week at most.ConclusionsOur results point to a skeptical attitude toward pregnancy self-monitoring among pregnant women. Nevertheless, many women are open to using devices for pregnancy monitoring in parallel to consulting their physician. The intention to use such devices several times daily or weekly, expressed by more than half of the participants, highlights the potential of such technologies.

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“…Importantly, knowledge of neurological abnormality in a child with alleged birth injury influences interpretations of monitoring tracings and judgments about the appropriateness of the clinical care provided. [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] "Birth injury" lawsuits are among the most expensive of claims. Birth injury cases accounted for half of British NHS litigation costs in 2013, almost 20% of the total budget for maternity services.…”

Section: Litigationmentioning

confidence: 99%

Electronic fetal monitoring, cerebral palsy, and caesarean section: assumptions versus evidence

Nelson

Sartwelle²,

Rouse

2016

BMJ

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Does knowledge of fetal outcome influence the interpretation of intrapartum cardiotocography and subsequent clinical management? A multicentre European study

Abstract: Knowledge of adverse fetal outcome leads to more pessimistic CTG evaluation and management recommendations.

Cited by 28 publications

References 28 publications

Low sensitivity of the new FIGO classification system for electronic fetal monitoring to identify fetal acidosis in the second stage of labor

Low sensitivity of the new FIGO classification system for electronic fetal monitoring to identify fetal acidosis in the second stage of labor

Women’s Attitudes Toward Self-Monitoring of Their Pregnancy Using Noninvasive Electronic Devices: Cross-Sectional Multicenter Study

Electronic fetal monitoring, cerebral palsy, and caesarean section: assumptions versus evidence

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