Experiences with intrapartum fetal monitoring in the Netherlands: A survey study

Habraken, Vera; Spanjers, Merel J.M.; Woude, Daisy A.A. van der; Oei, S.G.; Laar, Judith O E H van

doi:10.1016/j.ejogrb.2022.09.028

Cited by 2 publications

(2 citation statements)

References 23 publications

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“…This is in line with the results of previous studies which showed a good accuracy and reliability of NI‐fECG 11,17 . The percentage of women with a need to switch when using DU and TOCO is not completely known, although the use of FSE is estimated at 71% of all deliveries in the Netherlands 23 . Monson et al 20 reported that 39% of women with DU and TOCO monitoring switch to internal monitoring during labor.…”

Section: Discussionsupporting

confidence: 85%

“… 11 , 17 The percentage of women with a need to switch when using DU and TOCO is not completely known, although the use of FSE is estimated at 71% of all deliveries in the Netherlands. 23 Monson et al 20 reported that 39% of women with DU and TOCO monitoring switch to internal monitoring during labor. With non‐invasive electrophysiological monitoring, we were able to demonstrate a lower rate of switches to internal monitoring methods.…”

Section: Discussionmentioning

confidence: 99%

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Implementation of the combined use of non‐invasive fetal electrocardiography and electrohysterography during labor: A prospective clinical study

Frenken

Woude

Vullings

et al. 2023

Acta Obstet Gynecol Scand

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Introduction Fetal electrocardiography (NI‐fECG) and electrohysterography (EHG) have been proven more accurate and reliable than conventional non‐invasive methods (doppler ultrasound and tocodynamometry) and are less affected by maternal obesity. It is still unknown whether NI‐fECG and EHG will eliminate the need for invasive methods, such as the intrauterine pressure catheter and fetal scalp electrode. We studied whether NI‐fECG and EHG can be successfully used during labor. Material and Methods A prospective clinical pilot study was performed in a tertiary care teaching hospital. A total of 50 women were included with a singleton pregnancy with a gestational age between 36+0 and 42+0 weeks and had an indication for continuous intrapartum monitoring. The primary study outcome was the percentage of women with NI‐fECG and EHG monitoring throughout the whole delivery. Secondary study outcomes were reason and timing of a switch to conventional monitoring methods (i.e., tocodynamometry and fetal scalp electrode or doppler ultrasound), repositioning of the abdominal electrode patch, success rates (i.e., the percentage of time with signal output), and obstetric and neonatal outcomes. Clinical trial registration: Dutch trial register (NL8024). Results In 45 women (90%), NI‐fECG and EHG monitoring was used throughout the whole delivery. In the other five women (10%), there was a switch to conventional methods: in two women because of insufficient registration quality of uterine contractions and in three women because of insufficient registration quality of the fetal heart rate. In three out of five cases, the switch was after full dilation was reached. Repositioning of the abdominal electrode patch occurred in two women. The overall success rate was 94.5%. In 16% (n = 8) of women, a cesarean delivery was performed due to non‐progressing dilation (n = 7) and due to suspicion of fetal distress (n = 1). Neonatal metabolic acidosis did not occur. Two neonates (4%) were admitted to the neonatal intensive care unit for complications not related to intrapartum monitoring. Conclusions NI‐fECG and EHG can be successfully used during labor in 90% of women. Future research is needed to conclude whether implementation of electrophysiological monitoring can improve obstetric and neonatal outcomes.

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Section: Discussionsupporting

confidence: 85%