Clinical practice guidelines for intrapartum cardiotocography interpretation: A systematic review.

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Clinical Guidelines
Authored By
Brown J, Kanagaretnam D, Zen M
Authored On
Interests
Obstetrics & Gynecology
Cardiology
Radiology
Pediatric Medicine
Speciality
Cardiology
Obstetrics & Gynecology
Radiology
Pediatric Medicine
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volume
63
ISSN
1479-828X
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ISSN
1479-828X
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Additional Info
["Brown J, Kanagaretnam D, Zen M","Publisher: Wiley-Blackwell Country of Publication: Australia NLM ID: 0001027 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1479-828X (Electronic) Linking ISSN: 00048666 NLM ISO Abbreviation: Aust N Z J Obstet Gynaecol Subsets: MEDLINE","Systematic Review; Journal Article; Review","2023-06-01","The Australian & New Zealand journal of obstetrics & gynaecology [Aust N Z J Obstet Gynaecol] 2023 Jun; Vol. 63 (3), pp. 278-289. Date of Electronic Publication: 2023 Mar 10.","English","1479-828X","Fetal Hypoxia*\/diagnosis , Heart Rate, Fetal*, Pregnancy ; Female ; Humans ; Cardiotocography\/methods ; Consensus ; Databases, Factual","Pregnancy, Female, Humans, Cardiotocography methods, Consensus, Databases, Factual, Fetal Hypoxia diagnosis, Heart Rate, Fetal","The Australian & New Zealand journal of obstetrics & gynaecology","63"]
Description
Background: Clinical practice guidelines on intrapartum cardiotocography (CTG) interpretation provide structured tools to detect fetal hypoxia. Despite frequent use of different guidelines, little is known about their comparable consistency. We sought to appraise guidelines relevant to intrapartum CTG interpretation and summarise consensus and non-consensus recommendations.<br />Aims: To compare existing intrapartum CTG interpretation guidelines.<br />Materials and Methods: We searched PubMed, CINAHL, Cochrane, Embase, guideline databases and websites of guideline development institutions using terms 'cardiotocography', 'electronic fetal/foetal monitoring', and 'guideline' or equivalent term. The search was restricted to English-language articles published between January 1980 and January 2023 and excluded animal studies. The initial search yielded 2128 articles with 1253 unique citations. Guidelines were included if they: used English as the reporting language; included CTG interpretation criteria or guidelines as a primary objective; were published or updated since 1980; and were the most recently updated publications when multiple versions were identified.<br />Results: Nineteen studies were considered for full review, and 13 met inclusion criteria. Two reviewers independently assessed guideline quality using the AGREE II instrument, and synthesised consensus and non-consensus recommendations using the content analysis approach. Most guidelines employed a three-tier interpretation framework. There were significant differences between the guidelines for relative importance of key CTG features such as accelerations, decelerations and variability, with respect to the outcome of fetal hypoxia.<br />Conclusions: There are significant differences between key intrapartum CTG interpretation guidelines currently being used. Greater consistency is needed across CTG interpretation guidelines to improve the quality of data, clinical governance, monitoring of outcomes, and to support future developments.<br /> (© 2023 Royal Australian and New Zealand College of Obstetricians and Gynaecologists.)
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