Recognition and response to electronic fetal heart rate patterns: impact on newborn outcomes and primary cesarean delivery rate in women undergoing induction of labor - 02/04/15
, Janet A. Meyers, RN, Donna K. Frye, RN, Thomas Garthwaite, MD, Alan J. Lee, BS, Jonathan B. Perlin, MD, PhDAbstract |
Objective |
The objective of the study was to examine the clinical impact of specific fetal monitoring-related practices during induced labor.
Study Design |
This was a prospective, nonrandomized study.
Results |
We studied 14,398 women undergoing oxytocin induction of labor. A decrease in the infusion rate of oxytocin in the face of specified category II fetal heart rate tracings was associated with a significantly reduced rate of neonatal intensive care unit admission (3.8% vs 5.2%, P = .01) and Apgar score less than 7 at 1 and 5 minutes (4.9% vs 6.4%, P = .01, 0.6% vs 1.1%, P = .04). Compliance with an in-use checklist was associated with both a reduction in the rate of neonatal intensive care unit admission (2.9 vs 4.4, P = .00) and a reduction in the cesarean delivery rate (15.8% vs 18.8%, P = .00).
Conclusion |
Electronic fetal heart rate monitoring improves neonatal outcomes when unambiguous definitions of abnormal fetal heart rate and tachysystole are coupled with specific interventions. Utilization of a checklist for oxytocin monitoring is associated with improved neonatal outcomes and a reduction in the cesarean delivery rate.
Le texte complet de cet article est disponible en PDF.Key words : fetal heart rate monitoring, oxytocin, patient safety
Plan
| The authors report no conflict of interest. |
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| Cite this article as: Clark SL, Meyers JA, Frye DK, et al. Recognition and response to electronic fetal heart rate patterns: impact on newborn outcomes and primary cesarean delivery rate in women undergoing induction of labor. Am J Obstet Gynecol 2015;212:494.e1-6. |
Vol 212 - N° 4
P. 494.e1-494.e6 - avril 2015 Retour au numéro
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