Portal de Periódicos da CAPES

Knowledge of adverse neonatal outcome alters clinicians’ interpretation of the intrapartum cardiotocograph

2011; Wiley; Volume: 118; Issue: 8 Linguagem: Inglês

10.1111/j.1471-0528.2011.03003.x

1471-0528

Diogo Ayres‐de‐Campos, D. Arteiro, Cristina Santos, João Bernardes,

Neuroscience of respiration and sleep

BJOG: An International Journal of Obstetrics & GynaecologyVolume 118, Issue 8 p. 978-984 Intrapartum care Knowledge of adverse neonatal outcome alters clinicians' interpretation of the intrapartum cardiotocograph D Ayres-de-Campos, D Ayres-de-Campos Department of Obstetrics and Gynecology, Faculty of Medicine, University of Porto Department of Obstetrics and Gynecology, Sao Joao Hospital INEB – Institute of Biomedical Engineering, University of PortoSearch for more papers by this authorD Arteiro, D Arteiro Department of Obstetrics and Gynecology, Sao Joao HospitalSearch for more papers by this authorC Costa-Santos, C Costa-Santos Department of Biostatistics and Medical Informatics, Faculty of Medicine, University of Porto, Porto, PortugalSearch for more papers by this authorJ Bernardes, J Bernardes Department of Obstetrics and Gynecology, Faculty of Medicine, University of Porto Department of Obstetrics and Gynecology, Sao Joao Hospital INEB – Institute of Biomedical Engineering, University of PortoSearch for more papers by this author D Ayres-de-Campos, D Ayres-de-Campos Department of Obstetrics and Gynecology, Faculty of Medicine, University of Porto Department of Obstetrics and Gynecology, Sao Joao Hospital INEB – Institute of Biomedical Engineering, University of PortoSearch for more papers by this authorD Arteiro, D Arteiro Department of Obstetrics and Gynecology, Sao Joao HospitalSearch for more papers by this authorC Costa-Santos, C Costa-Santos Department of Biostatistics and Medical Informatics, Faculty of Medicine, University of Porto, Porto, PortugalSearch for more papers by this authorJ Bernardes, J Bernardes Department of Obstetrics and Gynecology, Faculty of Medicine, University of Porto Department of Obstetrics and Gynecology, Sao Joao Hospital INEB – Institute of Biomedical Engineering, University of PortoSearch for more papers by this author First published: 24 May 2011 https://doi.org/10.1111/j.1471-0528.2011.03003.xCitations: 32 Prof D Ayres-de-Campos, Departmento de Ginecologia e Obstetrícia, Faculdade de Medicina do Porto, 4200-309 Porto, Portugal. Email dcampos@med.up.pt Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Abstract Please cite this paper as: Ayres-de-Campos D, Arteiro D, Costa-Santos C, Bernardes J. Knowledge of adverse neonatal outcome alters clinicians' interpretation of the intrapartum cardiotocograph. BJOG 2011;978:985–984. Objective To evaluate the impact of knowledge of neonatal outcome on clinicians' interpretation of the intrapartum cardiotocograph (CTG). Design Prospective evaluation of pre-recorded cases. Setting Five maternity hospitals. Population From a database of intrapartum CTGs acquired with a scalp electrode in singleton near-term fetuses, 20 tracings were sequentially selected from cases with newborn umbilical artery pH < 7.05 and 20 from cases with pH > 7.20. Methods Five experienced obstetricians practising in different maternity hospitals were asked to analyse the 40 tracings individually, according to the International Federation of Gynaecology and Obstetrics guidelines. In a first round, clinicians were given no information on neonatal outcome. In a second round, carried out 2 months later, clinicians were asked to analyse the same tracings, but the order was randomly altered and information on the newborn's arterial pH was provided. Clinicians were not informed of the purpose of the study or whether the tracings were the same. Main outcome measures The incidence of individual fetal heart rate feature identification and tracing classification, before and after neonatal outcome was made available. Results In the group with pH < 7.05, repetitive decelerations and reduced variability were more common in the second round (P < 0.001 and P = 0.001, respectively), as was a pathological classification (P = 0.002); variable decelerations were less common (P = 0.008). In the group with normal pH, less tracings in the second round had prolonged decelerations (P = 0.013) and no accelerations (P = 0.013), but more had pronounced decelerations (P = 0.031) and reduced variability (P = 0.007); there was a reduction in pathological classifications, but this difference failed to reach statistical significance (P = 0.051). Conclusions A knowledge of adverse neonatal outcome leads to a more severe classification of the intrapartum CTG, which derives mainly from the evaluation of decelerations and variability. Citing Literature Supporting Information Data S1. Powerpoint slides summarising the study. Filename Description BJO_3003_sm_DataS1.ppt1.2 MB Supporting info item Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article. Volume118, Issue8July 2011Pages 978-984 This article also appears in:Journal Club RelatedInformation