Popular fetal monitoring method leads to more c-sections
Pregnant women in labor, upon arriving at the hospital, will often have their babys heart rate monitored to assess the babys wellbeing. A new research review suggests that the use of one popular method of monitoring does not improve maternal and fetal outcomes and makes women more likely to have cesarean sections.
Upon admission to many hospitals, a laboring womans babys heart rate commonly is checked by listening with a fetal stethoscope or a hand-held Doppler ultrasound device, known as intermittent auscultation, or with an electronic fetal monitoring machine that provides a printout of the babys heart rate and mothers contractions, known as cardiotocography (CTG).
The new review, published in The Cochrane Library, looked at how each type of monitoring affected women admitted to the hospital in labor with low-risk pregnancies and found there was no benefit of using the CTG at admission. However, women who had an admission CTG were about 20 percent more likely to have a caesarean section compared to those monitored by intermittent auscultation.
Researchers and clinicians thought the introduction of CTG would help to detect fetal distress and reduce the incidences of cerebral palsy or fetal and neonatal death. The problem with the CTG is that its use in maternity care became widespread before any high-quality evaluations of the benefits and risks it might bring for women and their infants had been conducted, said Declan Devane, professor of midwifery in the School of Nursing and Midwifery at National University of Ireland Galway and lead reviewer.
By the time the evidence arrived, its use in many units in many parts of the world had become ingrained in practice.
According to the review, about 79 percent of maternity wards in the United Kingdom, 96 percent in Ireland and all of the labor units in Sweden employ an admission CTG.
The review included four studies of more than 13,000 women randomized to receive either CTG or intermittent auscultation upon their admission with signs of labor.
Our findings support recommendations from professional bodies in some countries that state the admission CTG not be used for low-risk women, said Devane.
Lee Learman, M.D., chair of the department of obstetrics and gynecology at Indiana University School of Medicine, said the findings of the review do not apply to obstetrical care settings at his hospital or others in the U.S.
We do not perform an admission cardiotocograph for low-risk women and then switch to intermittent auscultation, as they did in the European studies, he said. Instead, we perform continuous monitoring for women of all risk groups when they are in labor.
Learman added that investigators in the U.S. have come to the same conclusion regarding the risk of using continuous electronic fetal heart rate monitoring.
We now know that this form of monitoring has not improved clinical outcomes, he explained. Instead, because of its inherent limitations, this form of monitoring leads to many false alarms that are resolved by performing cesarean delivery.
More information: Devane D., Lalor J.G., et al. (2012). Cardiotocography versus intermittent auscultation of fetal heart on admission to labour ward for assessment of fetal wellbeing. The Cochrane Library, Issue 2.
Provided by Health Behavior News Service
- Drug speeds up slow labor but doesn’t prevent C-sections Jul 15, 2011 | not rated yet | 0
- Northwestern researchers trial new device that may support improved newborn health Dec 21, 2011 | not rated yet | 0
- New study on maternity care published Nov 18, 2011 | not rated yet | 0
- Doppler ultrasound in pregnancy reduces risk in high-risk groups Jan 20, 2010 | not rated yet | 0
- How pregnancy changes a woman's brain Dec 21, 2011 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Classical and Quantum Mechanics via Lie algebras
Apr 15, 2011 I'd like to open a discussion thread for version 2 of the draft of my book ''Classical and Quantum Mechanics via Lie algebras'', available online at http://lanl.arxiv.org/abs/0810.1019 , and for the...
- More from Physics Forums - Independent Research
More news stories
Talking on a hands-free device while behind the wheel can lead to a sharp increase in errors that could imperil other drivers on the road, according to new research from the University of Alberta.
Health 17 hours ago | not rated yet | 0
(HealthDay)—More than one in four of those eligible for new premium assistance tax credits under the Affordable Care Act (ACA) do not have a checking account and will not be able to receive premiums from ...
Health 19 hours ago | not rated yet | 0
After studying noise in one French Quarter neighborhood of New Orleans to determine whether or not noise levels exceeded municipal ordinances, Annette Hurley, PhD, Assistant Professor of Audiology at LSU Health Sciences Center ...
Health 21 hours ago | not rated yet | 0
Young children who missed more than half of recommended well-child visits had up to twice the risk of hospitalization compared to children who attended most of their visits, according to a study published today in the American Jo ...
Health 21 hours ago | not rated yet | 0
The individualisation of drug treatments to support patients to self-manage their conditions is a concept that sits at the heart of policy, but a recent study in BMJ Open shows that there is no concrete defini ...
Health 23 hours ago | 3 / 5 (1) | 0
Coenzyme Q10 decreases all cause mortality by half, according to the results of a multicentre randomised double blind trial presented today at Heart Failure 2013 congress. It is the first drug to improve heart failure mortality ...
2 hours ago | not rated yet | 4
Heart failure accelerates the aging process and brings on early andropausal syndrome (AS), according to research presented today at the Heart Failure Congress 2013. AS, also referred to as male 'menopause', was four times ...
2 hours ago | not rated yet | 1
(AP)—Department of Justice lawyers have again asked a federal appeals court in New York to delay lifting age restrictions and prescription requirements on an emergency contraceptive popularly known as the morning-after ...
2 hours ago | not rated yet | 0
May 24, 2013 | 5 / 5 (3) | 0 |
Mortality and length of stay are highest in heart failure patients admitted in January, on Friday, and overnight, according to research presented today at the Heart Failure Congress 2013. The analysis of nearly 1 million ...
2 hours ago | not rated yet | 0
21 hours ago | 3.7 / 5 (3) | 2 |