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- Publisher Website: 10.1111/1471-0528.16731
- Scopus: eid_2-s2.0-85127958541
- PMID: 35415966
- WOS: WOS:000781627300001
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Article: Clinical algorithms for management of fetal heart rate abnormalities during labour
Title | Clinical algorithms for management of fetal heart rate abnormalities during labour |
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Authors | |
Keywords | Algorithm auscultation bradycardia deceleration Doptone fetal heart rate labour tachycardia |
Issue Date | 2022 |
Citation | BJOG: An International Journal of Obstetrics & Gynaecology, 2022 How to Cite? |
Abstract | Objective: To construct algorithms with a sequential decision analysis pathway for monitoring of the fetal heart rate and managing fetal heart rate bradycardia, late decelerations and tachycardia during labour. Population: Low-risk pregnant women in labour with singleton cephalic term pregnancies. Setting: Institutional births in low- and middle-income countries. Search strategy: We sought relevant published clinical algorithms, guidelines and randomised trials/reviews by searching the Cochrane Library, PubMed and Google on the terms: “fetal AND heart AND rate AND algorithm AND (labour OR intrapartum)”, up to March 2020. Case scenarios: The two scenarios included were fetal heart rate bradycardia or late decelerations (potentially related to uterine rupture, placental abruption, cord prolapse, maternal hypotension, uterine hyperstimulation or unexplained) and fetal heart rate tachycardia (potentially related to maternal hyperthermia, infection, dehydration or unexplained). The algorithms provide pathways for definition, assessment, diagnosis, interventions to correct the abnormalities and ongoing monitoring leading to mode of birth, and linking to other algorithms in the series. Conclusions: The algorithms provide a framework for monitoring and managing fetal heart rate bradycardia, late decelerations and tachycardia during labour. We emphasise the inherent diagnostic inaccuracy of fetal heart rate monitoring, the tendency to over-diagnose fetal compromise, the need to consider fetal heart rate information in the context of other clinical features and the need to engage in informed, shared, family-centred decision-making. We note the need for further research on methods of fetal assessment during labour including clinical fetal arousal testing and the rapid biophysical profile test. Tweetable abstract: Decision analysis algorithms for fetal bradycardia, late decelerations and tachycardia highlight diagnostic limitations. |
Persistent Identifier | http://hdl.handle.net/10722/313214 |
ISSN | 2023 Impact Factor: 4.7 2023 SCImago Journal Rankings: 1.858 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Cheung, KW | - |
dc.contributor.author | Bonet, M | - |
dc.contributor.author | Frank, KA | - |
dc.contributor.author | Oladapo, OT | - |
dc.contributor.author | Hofmeyr, GJ | - |
dc.contributor.author | Ciabati, L | - |
dc.contributor.author | De Oliveira, LL | - |
dc.contributor.author | Souza, R | - |
dc.contributor.author | Browne, J | - |
dc.contributor.author | Rijken, M | - |
dc.contributor.author | Fawcus, S | - |
dc.contributor.author | Hofmeyr, J | - |
dc.contributor.author | Liabsuetrakul, T | - |
dc.contributor.author | Gülümser, Ç | - |
dc.contributor.author | Blennerhassett, A | - |
dc.contributor.author | Lissauer, D | - |
dc.contributor.author | Meher, S | - |
dc.contributor.author | Althabe, F | - |
dc.contributor.author | Bonet, M | - |
dc.contributor.author | Metin Gülmezoglu, A | - |
dc.contributor.author | Oladapo, O | - |
dc.date.accessioned | 2022-06-06T05:47:43Z | - |
dc.date.available | 2022-06-06T05:47:43Z | - |
dc.date.issued | 2022 | - |
dc.identifier.citation | BJOG: An International Journal of Obstetrics & Gynaecology, 2022 | - |
dc.identifier.issn | 1470-0328 | - |
dc.identifier.uri | http://hdl.handle.net/10722/313214 | - |
dc.description.abstract | Objective: To construct algorithms with a sequential decision analysis pathway for monitoring of the fetal heart rate and managing fetal heart rate bradycardia, late decelerations and tachycardia during labour. Population: Low-risk pregnant women in labour with singleton cephalic term pregnancies. Setting: Institutional births in low- and middle-income countries. Search strategy: We sought relevant published clinical algorithms, guidelines and randomised trials/reviews by searching the Cochrane Library, PubMed and Google on the terms: “fetal AND heart AND rate AND algorithm AND (labour OR intrapartum)”, up to March 2020. Case scenarios: The two scenarios included were fetal heart rate bradycardia or late decelerations (potentially related to uterine rupture, placental abruption, cord prolapse, maternal hypotension, uterine hyperstimulation or unexplained) and fetal heart rate tachycardia (potentially related to maternal hyperthermia, infection, dehydration or unexplained). The algorithms provide pathways for definition, assessment, diagnosis, interventions to correct the abnormalities and ongoing monitoring leading to mode of birth, and linking to other algorithms in the series. Conclusions: The algorithms provide a framework for monitoring and managing fetal heart rate bradycardia, late decelerations and tachycardia during labour. We emphasise the inherent diagnostic inaccuracy of fetal heart rate monitoring, the tendency to over-diagnose fetal compromise, the need to consider fetal heart rate information in the context of other clinical features and the need to engage in informed, shared, family-centred decision-making. We note the need for further research on methods of fetal assessment during labour including clinical fetal arousal testing and the rapid biophysical profile test. Tweetable abstract: Decision analysis algorithms for fetal bradycardia, late decelerations and tachycardia highlight diagnostic limitations. | - |
dc.language | eng | - |
dc.relation.ispartof | BJOG: An International Journal of Obstetrics & Gynaecology | - |
dc.subject | Algorithm | - |
dc.subject | auscultation | - |
dc.subject | bradycardia | - |
dc.subject | deceleration | - |
dc.subject | Doptone | - |
dc.subject | fetal heart rate | - |
dc.subject | labour | - |
dc.subject | tachycardia | - |
dc.title | Clinical algorithms for management of fetal heart rate abnormalities during labour | - |
dc.type | Article | - |
dc.identifier.doi | 10.1111/1471-0528.16731 | - |
dc.identifier.pmid | 35415966 | - |
dc.identifier.scopus | eid_2-s2.0-85127958541 | - |
dc.identifier.hkuros | 333231 | - |
dc.identifier.isi | WOS:000781627300001 | - |