Electronic Fetal Monitoring and Cesarean Birth: A Scoping Review.
Birth
; 43(4): 277-284, 2016 12.
Article
em En
| MEDLINE
| ID: mdl-27565450
ABSTRACT
BACKGROUND:
In many United States hospitals, electronic fetal monitoring (EFM) is used continuously during labor for all patients regardless of risk status. Application of EFM, particularly at labor admission, may trigger a chain of interventions resulting in increased risk for cesarean birth among low-risk women. The goal of this review was to summarize evidence on use of EFM during low-risk labors and identify gaps in research.METHODS:
We conducted a scoping review of studies published in English since 1996 that addressed the relationship between EFM use and cesarean among low-risk women. We screened 57 full-text articles for appropriateness. Seven articles were included in the final review.RESULTS:
The largest study demonstrated an 81 percent increased risk of primary cesarean birth when EFM was used in labor, but did not differentiate between high- and low-risk pregnancies. Four randomized controlled trials examined the association of admission EFM with obstetric outcomes; only one considered cesarean birth as a primary outcome and found a 23 percent increase in operative birth when EFM lasted more than 1 hour. A study examining application of continuous EFM before and after 4 centimeters dilatation found no differences between groups.CONCLUSIONS:
In general, the research on this topic suggests an association between the use of EFM and cesarean birth; however, more well-designed studies are needed to examine benefits of EFM versus auscultation, determine if EFM is associated with use of other technologies that could cumulatively increase risk of cesarean birth, and understand provider motivation to use EFM over auscultation.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cardiotocografia
/
Cesárea
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Systematic_reviews
Limite:
Female
/
Humans
/
Infant
/
Pregnancy
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Birth
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Estados Unidos