Guideline on fetal monitoring in labour

Editor, The

doi:10.4038/sljog.v35i4.6602

Cited by 1 publication

(4 citation statements)

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“…All guidelines considered a fetal heart rate below 100 BPM to be abnormal and a feature of the highest possible risk category. Four guidelines (DGGG, NICE, SLCOG, WALES) considered fetal tachycardia above 180 BPM to also meet criteria for the highest risk category 16,18,23,25 . Most guidelines noted a baseline between 100–110 BPM and 160–180 BPM to be a Suspicious feature.…”

Section: Resultsmentioning

confidence: 99%

“…There was considerable variation in the role of fetal heart rate accelerations in intrapartum CTG interpretation. Three guidelines (DGGG, SLCOG, SOGC) describe accelerations as a necessary feature of a Normal CTG, 16,23,24 whereas the other guidelines deem that accelerations can be present or absent and/or have an uncertain significance in the interpretation of fetal compromise. This is carried over into the Suspicious and Abnormal categories where only the SOGC guideline describe absent accelerations as a feature of an Abnormal CTG 24 …”

Section: Resultsmentioning

confidence: 99%

“…Four guidelines (DGGG, NICE, SLCOG, WALES) considered fetal tachycardia above 180 BPM to also meet criteria for the highest risk category. 16,18,23,25 Most guidelines noted a baseline between 100-110 BPM and 160-180 BPM to be a Suspicious feature. Only two guidelines (NICE, SOGC) included a rise in baseline (without breaching the above limits) as a Suspicious feature.…”

Section: Fetal Baseline Heart Ratementioning

confidence: 99%

“…All guidelines agree that absence of decelerations was a Normal CTG feature-and two (DGGG, SLCOG) indicated that presence of any decelerations was a Suspicious or Abnormal finding. 16,23 That is, only a CTG with no decelerations could be considered in the Normal category.…”

Section: Decelerationsmentioning

confidence: 99%

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Clinical practice guidelines for intrapartum cardiotocography interpretation: A systematic review

Brown

Kanagaretnam

Zen

2023

Aust NZ J Obst Gynaeco

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Background Clinical practice guidelines on intrapartum cardiotocography (CTG) interpretation provide structured tools to detect fetal hypoxia. Despite frequent use of different guidelines, little is known about their comparable consistency. We sought to appraise guidelines relevant to intrapartum CTG interpretation and summarise consensus and non‐consensus recommendations. Aims To compare existing intrapartum CTG interpretation guidelines. Materials and methods We searched PubMed, CINAHL, Cochrane, Embase, guideline databases and websites of guideline development institutions using terms ‘cardiotocography’, ‘electronic fetal/foetal monitoring’, and ‘guideline’ or equivalent term. The search was restricted to English‐language articles published between January 1980 and January 2023 and excluded animal studies. The initial search yielded 2128 articles with 1253 unique citations. Guidelines were included if they: used English as the reporting language; included CTG interpretation criteria or guidelines as a primary objective; were published or updated since 1980; and were the most recently updated publications when multiple versions were identified. Results Nineteen studies were considered for full review, and 13 met inclusion criteria. Two reviewers independently assessed guideline quality using the AGREE II instrument, and synthesised consensus and non‐consensus recommendations using the content analysis approach. Most guidelines employed a three‐tier interpretation framework. There were significant differences between the guidelines for relative importance of key CTG features such as accelerations, decelerations and variability, with respect to the outcome of fetal hypoxia. Conclusions There are significant differences between key intrapartum CTG interpretation guidelines currently being used. Greater consistency is needed across CTG interpretation guidelines to improve the quality of data, clinical governance, monitoring of outcomes, and to support future developments.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Fetal Baseline Heart Ratementioning

confidence: 99%

Section: Decelerationsmentioning

confidence: 99%

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