Intermittent auscultation (surveillance) of fetal heart rate in labor: a progressive evidence-backed approach with aim to improve methodology, reliability and safety

References

• National Institute for Health and Clinical Excellence. National Collaborating Centre for Women's and Children's Health. Intrapartum care – care of healthy women and their babies during childbirth. Guideline No 190. 2014. London (UK): National Institute for Health and Clinical Excellence.
   Google Scholar
• The Society of Obstetrician and Gynecologists of Canada. Fetal health surveillance: antepartum and intrapartum consensus guideline. J Obstet Gynaecol Canada. 2007;29(9):S3–S4.
   PubMedGoogle Scholar
• The Royal Australian and New Zealand College of Obstetricians and Gynaecologist. Intrapartum fetal surveillance clinical guideline. 3rd ed. East Melbourne: The Royal Australian and New Zealand College of Obstetricians and Gynaecologist; 2014.
   Google Scholar
• American College of Nurse-Midwives. Intermittent auscultation for intrapartum fetal heart rate surveillance. J Midwifery Womens Health. 2015;60:626–632.
   PubMed Web of Science ®Google Scholar
• Debrah Lewis D, Downe S. FIGO consensus guidelines on intrapartum fetal monitoring: intermittent auscultation. Int J Gynaecol Obstet. 2015;131;(1):9–12.
   PubMed Web of Science ®Google Scholar
• Sholapurkar S L. This study demonstrates that the “cumulative deceleration area” performs poorly and the study data calls for scientific classification of FHR decelerations. J Matern Fetal Neonatal Med. 2020:1–2. DOI:https://doi.org/10.1080/14767058.2020.1759537
   Google Scholar
• Campanile M, D'Alessandro P, Della Corte L, et al. Intrapartum cardiotocography with and without computer analysis: a systematic review and meta-analysis of randomized controlled trials. J Matern Fetal Neonatal Med. 2018;18:1–7.
   Google Scholar
• Harding C, Johnson D. Intelligent intermittent auscultation. eFM. E-learning for healthcare. London: The Royal College of Obstetricians and Gynaecologists; 2017. https://portal.elfh.org.uk/LearningContent/Launch/515455
   Google Scholar
• K2MS™ Perinatal Training Programme (PTP). Intrapartum intermittent auscultation. K2 Medical Systems™, Plymouth, United Kingdom. [cied 2020 Jul 15]. Available from http://training.k2ms.com/UserHome.aspx#.
   Google Scholar
• Lowe V, Archer A. Handbook of CTG interpretation: from patterns to physiology. 1st ed. Cambridge: Cambridge University Press; 2017. Chapter 8, Intermittent (intelligent) auscultation in the low-risk setting; p. 55–58.
   Google Scholar
• WHO recommendations: intrapartum care for a positive childbirth experience. Geneva: World Health Organization; 2018. Licence: CC BY-NC-SA 3.0 IGO. https://apps.who.int/iris/bitstream/handle/10665/260178/9789241550215eng.pdf;jsessionid=096E365C7CDEC7B2C0F201DDBB446DD3?sequence=1.
   Google Scholar
• Sholapurkar SL. Intermittent auscultation in labor: could it be missing many pathological (late) fetal heart rate decelerations? Analytical review and rationale for improvement supported by clinical cases. J Clin Med Res. 2015;7(12):919–925.
   PubMedGoogle Scholar
• Blix E, Maude R, Hals E, et al. Intermittent auscultation fetal monitoring during labour: a systematic scoping review to identify methods, effects, and accuracy. PLoS One. 2019;14(7):e0219573
   PubMed Web of Science ®Google Scholar
• Bookstein FL. Measuring and reasoning – numerical inferences in sciences. 1st ed. Cambridge, UK: Cambridge University Press; 2014. Chapter 8.3, What, then, IS to be done? p. 493–500.
   Google Scholar
• Schünemann HJ, Zhang Y, Oxman AD. Distinguishing opinion from evidence in guidelines. BMJ. 2019;366:l4606.
   PubMed Web of Science ®Google Scholar
• Amrhein V, Greenland S, McShane B. Scientists rise up against statistical significance. Nature. 2019;567(7748):305–307.
   PubMed Web of Science ®Google Scholar
• Ayres-de-Campos D, Spong CY, Chandraharan E. FIGO consensus guidelines on intrapartum fetal monitoring: Cardiotocography. Int Int J Gynaecol Obstet. 2015;131(1):13–24.
   PubMed Web of Science ®Google Scholar
• Encyclopaedia Britannica. Occam’s razor | Origin, examples, & facts | Britannica.com. [cited 2019 Jul 1]. https://www.britannica.com/topic/Occams-razor.
   Google Scholar
• Kahneman D. Thinking, fast and slow. 1st ed. London, UK: Penguin Random House; 2012. Chapter 21, Intuitions vs formulas; p. 222–233.
   Google Scholar
• KISS principle. Wikipedia, the free encyclopedia. https://en.wikipedia.org/wiki/KISS_principle.
   Google Scholar
• Maude RM, Skinner JP, Foureur MJ. Intelligent Structured Intermittent Auscultation (ISIA): evaluation of a decision-making framework for fetal heart monitoring of low-risk women. BMC Pregnancy Childbirth. 2014;14:184.
   PubMed Web of Science ®Google Scholar
• Cahill AG, Roehl KA, Odibo AO, Macones GA. Association and prediction of neonatal acidemia. Am J Obstet Gynecol. 2012;207(3):206.e1.
   PubMed Web of Science ®Google Scholar
• Hon EH. The electronic evaluation of the fetal heart rate; preliminary report. Am J Obstet Gynecol. 1958;75(6):1215–1230.
   PubMed Web of Science ®Google Scholar
• Royal College of Obstetricians and Gynaecologists. Clinical Effectiveness Support Unit. The use of electronic fetal monitoring. The use and interpretation of cardiotocography, in intrapartum fetal surveillance. Evidence based Clinical Guideline No 8. London (UK): RCOG Press; 2001.
   Google Scholar
• Each Baby Counts. London: Royal College of Obstetricians and Gynaecologists. 2020 [cited 2020 Feb]. https://www.rcog.org.uk/eachbabycounts.
   Google Scholar
• Menticoglou SM, Harman CR. Problems in the detection of intrapartum fetal asphyxia with intermittent auscultation. Aust N Z J Obstet Gynaecol. 1999;39(2):218–222.
   PubMed Web of Science ®Google Scholar
• Devane D, Lalor JG, Daly S, et al. Cardiotocography versus intermittent auscultation of fetal heart onadmission to labour ward for assessment of fetal wellbeing. Cochrane Database Syst Rev2017;(1):CD005122. https://doi.org/10.1002/14651858.CD005122.pub5.
   Google Scholar
• Sholapurkar SL. Trace display Doppler monitors. Br J Midwifery. 2017;25(5):282–283.
   Google Scholar
• Kamala BA, Wangwe PJ, Dalen I, et al. Intrapartum fetal heart rate monitoring using a handheld Doppler versus Pinard stethoscope: a randomized controlled study in Dar es Salaam. IJWH. 2018;10:341–348.
   PubMed Web of Science ®Google Scholar
• Mdoe PF, Ersdal HL, Mduma ER, et al. Intermittent fetal heart rate monitoring using a fetoscope or hand held Doppler in rural Tanzania: a randomized controlled trial. BMC Pregnancy Childbirth. 2018;18(1):134.
   PubMed Web of Science ®Google Scholar
• Byaruhanga R, Bassani DG, Jagau A, et al. Use of wind-up fetal Doppler versus Pinard for fetal heart rate intermittent monitoring in labour: a randomised clinical trial. BMJ Open. 2015;5(1):e006867.
   PubMed Web of Science ®Google Scholar
• Mahomed K, Nyoni R, Mulambo T, et al. Randomised controlled trial of intrapartum fetal heart rate monitoring. BMJ. 1994;308(6927):497–500.
   PubMed Web of Science ®Google Scholar
• IMPAC (Integrated Management of Pregnancy and Childbirth). Pregnancy, childbirth, postpartum and newborn care. A guide for essential practice. World Health Organization, United Nations Population Fund, UNICEF, The World Bank; 2006 [cited 2017 May 1]. http://www.who.int/maternal_child_adolescent/documents/924159084x/en/.
   Google Scholar
• Spiegelhalter D. The art of statistics: Learning from data. 1st ed. Milton Keynes (UK): Penguin Random House UK; 2019. Chapter 10, Answering questions and claiming discoveries. Learning from experience the Bayesian way; p. 253–339.
   Google Scholar
• Sholapurkar SL. Intermittent auscultation of fetal heart rate during labour – a widely accepted technique for low risk pregnancies: but are the current national guidelines robust and practical? J Obstet Gynaecol. 2010;30(6):537–540.
   PubMedGoogle Scholar