Cristin-resultat-ID: 1712730
Sist endret: 18. februar 2020 13:15
NVI-rapporteringsår: 2019
Resultat
Vitenskapelig oversiktsartikkel/review
2019

Intermittent auscultation fetal monitoring during labour: A systematic scoping review to identify methods, effects, and accuracy

Bidragsytere:
  • Ellen Blix
  • Robyn Maude
  • Elisabeth Hals
  • Sezer Kisa
  • Elisabeth Karlsen
  • Ellen Aagaard Nøhr
  • mfl.

Tidsskrift

PLOS ONE
ISSN 1932-6203
e-ISSN 1932-6203
NVI-nivå 1

Om resultatet

Vitenskapelig oversiktsartikkel/review
Publiseringsår: 2019
Publisert online: 2019
Volum: 14
Hefte: 7
Artikkelnummer: e0219573
Open Access

Importkilder

Scopus-ID: 2-s2.0-85069555650

Beskrivelse Beskrivelse

Tittel

Intermittent auscultation fetal monitoring during labour: A systematic scoping review to identify methods, effects, and accuracy

Sammendrag

Background Intermittent auscultation (IA) is the technique of listening to and counting the fetal heart rate (FHR) for short periods during active labour and continuous cardiotocography (CTC) implies FHR monitoring for longer periods. Although the evidence suggests that IA is the best way to monitor healthy women at low risk of complications, there is no scientific evidence for the ideal device, timing, frequency and duration for IA. We aimed to give an overview of the field, identify and describe methods and practices for performing IA, map the evidence and accuracy for different methods of IA, and identify research gaps. Methods We conducted a systematic scoping review following the Joanna Briggs methodology. Medline, EMBASE, Cinahl, Maternity & Infant Care, Cochrane Library, SveMed+, Web of Science, Scopus, Lilacs and African Journals Online were searched for publications up to January 2019. We did hand searches in relevant articles and databases. Studies from all countries, international guidelines and national guidelines from Denmark, United Kingdom, United States, New Zealand, Australia, The Netherlands, Sweden, Denmark, and Norway were included. We did quality assessment of the guidelines according to the AGREEMENT tool. We performed a meta-analysis assessing the effects of IA with a Doppler device vs. Pinard device using methods described in TheCochrane Handbook, and we performed an overall assessment of the summary of evidence using the GRADE approach. Results The searches generated 6408 hits of which 26 studies and 11 guidelines were included in the review. The studies described slightly different techniques for performing IA, and some did not provide detailed descriptions. Few of the studies provided details of normal and abnormal IA findings. All 11 guidelines recommended IA for low risk women, although they had slightly different recommendations on the frequency, timing, and duration for IA, and the FHR characteristics that should be observed. Four of the included studies, comprising 8436 women and their babies, were randomised controlled trials that evaluated the effect of IA with a Doppler device vs. a Pinard device. Abnormal FHRs were detected more often using the Doppler device than in those using the Pinard device (risk ratio 1.77; 95% confidence interval 1.29–2.43). There were no significant differences in any of the other maternal or neonatal outcomes. Four studies assessed the accuracy of IA findings. Normal FHR was easiest to identify correctly, whereas identifying periodic FHR patterns such as decelerations and saltatory patterns were more difficult. Conclusion Although IA is the recommended method, no trials have been published that evaluate protocols on how to perform it. Nor has any study assessed interrater agreements regarding interpretations of IA findings, and few have assessed to what degree clinicians can describe FHR patterns detected by IA. We found no evidence to recommend Doppler device instead of the Pinard for IA, or vice versa.

Bidragsytere

Aktiv cristin-person

Ellen Blix

  • Tilknyttet:
    Forfatter
    ved Institutt for sykepleie og helsefremmende arbeid ved OsloMet - storbyuniversitetet

Robyn Maude

  • Tilknyttet:
    Forfatter
    ved Victoria University of Wellington

Elisabeth Hals

  • Tilknyttet:
    Forfatter
    ved Div Lillehammer ved Sykehuset Innlandet HF

Sezer Kisa

  • Tilknyttet:
    Forfatter
    ved Institutt for sykepleie og helsefremmende arbeid ved OsloMet - storbyuniversitetet

Elisabeth Karlsen

  • Tilknyttet:
    Forfatter
    ved Universitetsbiblioteket ved OsloMet - storbyuniversitetet
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