Fetal heart rate monitoring protocols during normal labour: indications and benefits
L'Agence Nationale d'Accreditation d'Evaluation en Sante (ANAES)
Record ID 32003000040
French
Authors' objectives:
To assess the relative benefits of intermittent auscultation and continuous cardiotocographic recording for fetal heart rate (FHR) monitoring in low-risk labour.
Authors' results and conclusions:
(i) Current practice. Cardiotocography is the method almost always used to monitor FHR. It is a sensitive method which gives a high level of false positive results and has a substantial negative predictive value. Considerable intra- and inter-observer variation reflect problems both with reading and with interpreting traces, and the fact that the definitions and classifications used are not standardised.
(ii) Studies selected. Our assessment was based on the main findings of 3 meta-analyses and 10 randomised controlled trials. Most of these trials were old, lacked power, and were performed under controlled conditions not applicable in clinical practice.
(iii) Efficacy and safety of cardiotocography compared to intermittent auscultation: No superiority in terms of perinatal mortality; fewer seizures (following secondary analyses after oxytocin use); increased use of invasive procedures (Caesareans and forceps or vacuum extraction).
(iv) Advantages specific to cardiotocography: Traceability of events and better defence provided in the event of a complaint.
Authors' recommendations:
Opinion of the working group. As recommended in guidelines from other countries, intermittent auscultation may be used in low-risk situations if its use is strictly controlled (midwife at bedside of woman in labour).
Authors' methods:
Review
Details
Project Status:
Completed
URL for project:
http://www.has-sante.fr/
Year Published:
2002
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
France
MeSH Terms
- Cardiotocography
- Fetal Monitoring
- Heart Auscultation
- Heart Rate, Fetal
- Labor, Obstetric
Contact
Organisation Name:
L'Agence Nationale d'Accreditation d'Evaluation en Santé
Contact Address:
2 avenue du Stade de France, 93218 Saint-Denis La Plaine Cedex, France. Tel: +33 01 55 93 71 88; Fax: +33 01 55 93 74 35;
Contact Name:
sh.leerobin@has-sante.fr
Contact Email:
sh.leerobin@has-sante.fr
Copyright:
L'Agence Nationale d'Accreditation d'Evaluation en Sante (ANAES)
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