TY - JOUR
T1 - Delphi consensus statement on intrapartum fetal monitoring in low-resource settings
AU - Housseine, Natasha
AU - Punt, Marieke C.
AU - Browne, Joyce L.
AU - van ‘t Hooft, Janneke
AU - Maaløe, Nanna
AU - Meguid, Tarek
AU - Theron, Gerhard B.
AU - Franx, Arie
AU - Grobbee, Diederick E.
AU - Visser, Gerard H. A.
AU - Rijken, Marcus J.
PY - 2019
Y1 - 2019
N2 - Objective: To determine acceptable and achievable strategies of intrapartum fetal monitoring in busy low-resource settings. Methods: Three rounds of online Delphi surveys were conducted between January 1 and October 31, 2017. International experts with experience in low-resource settings scored the importance of intrapartum fetal monitoring methods. Results: 71 experts completed all three rounds (28 midwives, 43 obstetricians). Consensus was reached on (1) need for an admission test, (2) handheld Doppler for intrapartum fetal monitoring, (3) intermittent auscultation (IA) every 30 minutes for low-risk pregnancies during the first stage of labor and after every contraction for high-risk pregnancies in the second stage, (4) contraction monitoring hourly for low-risk pregnancies in the first stage, and (5) adjunctive tests. Consensus was not reached on frequency of IA or contraction monitoring for high-risk women in the first stage or low-risk women in the second stage of labor. Conclusion: There is a gap between international recommendations and what is physically possible in many labor wards in low-resource settings. Research on how to effectively implement the consensus on fetal assessment at admission and use of handheld Doppler during labor and delivery is crucial to support staff in achieving the best possible care in low-resource settings.
AB - Objective: To determine acceptable and achievable strategies of intrapartum fetal monitoring in busy low-resource settings. Methods: Three rounds of online Delphi surveys were conducted between January 1 and October 31, 2017. International experts with experience in low-resource settings scored the importance of intrapartum fetal monitoring methods. Results: 71 experts completed all three rounds (28 midwives, 43 obstetricians). Consensus was reached on (1) need for an admission test, (2) handheld Doppler for intrapartum fetal monitoring, (3) intermittent auscultation (IA) every 30 minutes for low-risk pregnancies during the first stage of labor and after every contraction for high-risk pregnancies in the second stage, (4) contraction monitoring hourly for low-risk pregnancies in the first stage, and (5) adjunctive tests. Consensus was not reached on frequency of IA or contraction monitoring for high-risk women in the first stage or low-risk women in the second stage of labor. Conclusion: There is a gap between international recommendations and what is physically possible in many labor wards in low-resource settings. Research on how to effectively implement the consensus on fetal assessment at admission and use of handheld Doppler during labor and delivery is crucial to support staff in achieving the best possible care in low-resource settings.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85059029497&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/30582153
U2 - https://doi.org/10.1002/ijgo.12724
DO - https://doi.org/10.1002/ijgo.12724
M3 - Article
C2 - 30582153
SN - 0020-7292
VL - 146
SP - 8
EP - 16
JO - International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
JF - International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
IS - 1
ER -