Comparative study between intermittent auscultation and cardiotocogram in low risk group during labour in Libya
DOI:
https://doi.org/10.54361/ljmr.v8i1.02Abstract
The goal of fetal heart rate monitoring has been early identification of the fetus at risk for hypoxic insult. The aim of this study is to establish the relation between FHR monitoring (CTG, intermittent auscultation) and fetal outcome and mode of delivery. It is prospective observational comparative study carried out in Zawia hospital maternity word. Study population consists of 200 women in labor having the criteria of low risk group included singleton pregnancies between 37 - 40 weeks gestation, half of them monitored by intermittent auscultation and the other half by CTG. In this study, 200 women, 100 of them fetal monitoring was done by continuous electronic monitoring by CTG, the other monitored by intermittent auscultation by pinard stethoscope. Caesarean sections were performed for 31% and 6% of both groups (electronic monitoring and pinard stethoscope) respectively, statistically significant. There are three cases delivered by instrumental delivery (ventose) one in CTG and two in fetoscpo group. Abnormality in fetal heart rate was detected in (12%) of electronic monitoring group (3.5%) of the pinard stethoscope group. The apgar score of babies in both group nearly the same (p = 0.411). The babies whose transferred in intensive care unit is higher in CTG group (26 - 20%, 9 - 6%, p = 0.374). One in CTG group has neonatal seizure. It is concluded that abnormalities in fetal heart rate were more reliably detected by electronic monitoring than with pinard stethoscope. Uses of continuous electronic monitoring carry high rate of cesarean section with no significant difference in neonatal outcome.
Downloads
References
Steer PJ, Eigbe MB, Lissauer MB and Beard RW. Interrelationships among abnormal cardiotocogr-ams in labour, meconium staining of the amniotic fluid, arterial cord blood pH, and Apgar scores. Obstet Gynecol. 1989, 74: 715-721.
Killan and Goodlin R. History of fetal monitoring. Am J Obstet Gynecol. 1979, 133: 325.
Grant A. Monitoring the fetus during labour. In: Chalmers I, Enkin M, Kierse Marc JNC, eds. Effective care in pregnancy and childbirth. vol 2. Oxford University Press, 1989, 846-882.
MacDonald D, Grant A, Sheridan-Perreira M, Boylan P and Chalmers I. The Dublin randomised trial of intrapartum fetal heart monitoring. Am J Obstet Gynecol. 1985, 152: 524- 539.
Arulkumaran S and Ingemarsson I. Appropriate technology in intrapartum fetal surveillance. In: Studd J, ed. Progress in obstetrics and gynaecology. vol 8: Edinburgh: Churchill Livingstone, 1990, 127-140.
Philpott RH and Castle WM. Cervicographs in the management of labour on primigravidae. I: The alert line for detecting abnormal labour. J Obstet Gynaecol Br Commnw. 1972, 79: 592-598.
Philpott RH and Castle WM. Cervicographs in the management of labour in primigravidae. II: The action line and treatment of abnormal labour. J Obstet Gynaecol Br Commnw. 1972, 79: 599-602.
Hon EH. The electronic evaluation of the fetal heart rate. Am J Obstet Gynecol. 1958, 75: 1215.
Grant A. Monitoring the fetus during labour. In: Chalmers I, Enkin M, Kierse Marc JNC, eds. Effective care in pregnancy and childbirth. Vol 2: Oxford: Oxford University Press, 1989, 846-882.
Haverkamp AD, Thompson HE, McFee JG and Cetrulo C. The evaluation of continuous fetal heart rate monitoring in high risk pregnancy. Am J Obstet Gynecol. 1986; 125: 310-320.
Renou P, Chang J, Anderson I, Wood C. Controlled trial of fetal intensive care. Am J Obstet Gynecol. 1976, 126: 470-476.
Haverkamp AD, Orleans M, Langendoerfer S, McFee J, Murphy J and Thompson HE. A controlled trial of the differential effect of Intrapartum fetal monitoring. Am J Obstet Gynecol. 1979, 134: 399-408.
Graham EM, Petersen SM and Christo DK. Intrapartum electronic fetal heart rate monitoring and the prevention of perinatal brain injury. Obstet Gynecol. 2006, 108: 656-666.
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.
Liston R, Crane J and Hamilton E. Fetal health surveillance in labour. J Obstet Gyaecol Can. 2002, 24; 3: 250 - 276; quiz 277-280.
Thacker SB, Stroup SB and Chang M. Continuous electronic heart rate monitoring for fetal assessment during labor Cohrane Database Syst Rev. 2000, 2: CD000063.
MacDonald D, Grant A, Sheridan-Perreira M, Boylan P and Chalmers I. The Dublin randomised trial of intrapartum fetal heart monitoring. Am J Obstet Gynecol. 1985, 152: 524- 539.
Sarnat HB and Sarnat MS. Potential new therapies for perinatal cerebral hypoxic ischaemia. In: Sankaran S, ed. Clinics in Perinatology. Philadelphia W B Saunders, 1993, 411.
Downloads
Published
Issue
Section
License
Copyright (c) 2014 Karima T. Hawisa, Nehad Gabassa (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Open Access Policy
Libyan journal of medical Research (LJMR).is an open journal, therefore there are no fees required for downloading any publication from the journal website by authors, readers, and institution.
The journal applies the license of CC BY (a Creative Commons Attribution 4.0 International license). This license allows authors to keep ownership f the copyright of their papers. But this license permits any user to download , print out, extract, reuse, archive, and distribute the article, so long as appropriate credit is given to the authors and the source of the work.
The license ensures that the article will be available as widely as possible and that the article can be included in any scientific archive.
Editorial Policy
The publication of an article in a peer reviewed journal is an essential model for Libyan journal of medical Research (LJMR). It is necessary to agree upon standards of expected ethical behavior for all parties involved in the act of publishing: the author, the journal editorial, the peer reviewer and the publisher.
Any manuscript or substantial parts of it, submitted to the journal must not be under consideration by any other journal. In general, the manuscript should not have already been published in any journal or other citable form, although it may have been deposited on a preprint server. Authors are required to ensure that no material submitted as part of a manuscript infringes existing copyrights, or the rights of a third party.
Authorship Policy
The manuscript authorship should be limited to those who have made a significant contribution and intellectual input to the research submitted to the journal, including design, performance, interpretation of the reported study, and writing the manuscript. All those who have made significant contributions should be listed as co-authors.
Others who have participated in certain substantive aspects of the manuscript but without intellectual input should only be recognized in the acknowledgements section of the manuscript. Also, one of the authors should be selected as the corresponding author to communicate with the journal and approve the final version of the manuscript for publication in the LJMR.
Peer-review Policy
- All the manuscripts submitted to LJMR will be subjected to the double-blinded peer-review process;
- The manuscript will be reviewed by two suitable experts in the respective subject area.
- Reports of all the reviewers will be considered while deciding on acceptance/revision or rejection of a manuscript.
- Editor-In-Chief will make the final decision, based on the reviewer’s comments.
- Editor-In-Chief can ask one or more advisory board members for their suggestions upon a manuscript, before making the final decision.
- Associate editor and review editors provide administrative support to maintain the integrity of the peer-review process.
- In case, authors challenge the editor’s negative decision with suitable arguments, the manuscript can be sent to one more reviewer and the final decision will be made based upon his recommendations.
