Document Detail


Plymouth randomized trial of cardiotocogram only versus ST waveform plus cardiotocogram for intrapartum monitoring in 2400 cases.
MedLine Citation:
PMID:  8238177     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The physiology of changes in the ST waveform of the fetal electrocardiogram has been elucidated in extensive animal and human observational studies. A combination of heart rate and ST waveform analysis might improve the predictive value of intrapartum monitoring. Our purpose was to compare operative intervention and neonatal outcome in labors monitored by the conventional cardiotocogram with those monitored by ST waveform plus the cardiotocogram. STUDY DESIGN: A prospective, randomized clinical trial was performed on 2434 high-risk labors in a district general hospital in Plymouth, England. Statistical analysis was performed by Student t test and chi 2 analysis. RESULTS: There was a 46% reduction (p < 0.001, odds ratio 1.85 [1.35-2.66]) in operative deliveries for "fetal distress" and a trend to less metabolic acidosis (p = 0.09, odds ratio 0.38 [0.13-1.07]) and fewer low 5-minute Apgar scores (p = 0.12, odds ratio 0.62 [0.35-1.08]) in the ST waveform plus cardiotocogram arm. CONCLUSIONS: ST waveform analysis discriminates cardiotocogram changes in labor, and the protocol for interpretation is safe. Further randomized studies are warranted.
Authors:
J Westgate; M Harris; J S Curnow; K R Greene
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  169     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  1993 Nov 
Date Detail:
Created Date:  1993-12-15     Completed Date:  1993-12-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1151-60     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics, Postgraduate Medical School, Plymouth General Hospital, England.
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MeSH Terms
Descriptor/Qualifier:
Blood Gas Analysis
Cardiotocography*
Cesarean Section
Electrocardiography*
Female
Fetal Blood
Fetal Heart
Fetal Monitoring*
Heart Rate
Humans
Labor, Obstetric*
Pregnancy
Pregnancy Outcome
Prospective Studies
Quality Assurance, Health Care
Comments/Corrections
Comment In:
Am J Obstet Gynecol. 1994 Sep;171(3):867-8   [PMID:  8092245 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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