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- Title
A critical appraisal of the evidence for using cardiotocography plus ECG ST interval analysis for fetal surveillance in labor. Part II: the meta-analyses.
- Authors
Olofsson, Per; Ayres‐de‐Campos, Diogo; Kessler, Jörg; Tendal, Britta; Yli, Branka M.; Devoe, Lawrence
- Abstract
We appraised the methodology, execution and quality of the five published meta-analyses that are based on the five randomized controlled trials which compared cardiotocography ( CTG)+ ST analysis to cardiotocography. The meta-analyses contained errors, either created de novo in handling of original data or from a failure to recognize essential differences among the randomized controlled trials, particularly in their inclusion criteria and outcome parameters. No meta-analysis contained complete and relevant data from all five randomized controlled trials. We believe that one randomized controlled trial excluded in two of the meta-analyses should have been included, whereas one randomized controlled trial that was included in all meta-analyses, should have been excluded. After correction of the uncovered errors and exclusion of the randomized controlled trial that we deemed inappropriate, our new meta-analysis showed that CTG+ ST monitoring significantly reduces the fetal scalp blood sampling usage (risk ratio 0.64; 95% confidence interval 0.47-0.88), total operative delivery rate (0.93; 0.88-0.99) and metabolic acidosis rate (0.61; 0.41-0.91).
- Subjects
FETAL heart rate monitoring; ELECTROCARDIOGRAPHY; META-analysis; RANDOMIZED controlled trials; BLOOD sampling; ACIDOSIS research
- Publication
Acta Obstetricia et Gynecologica Scandinavica, 2014, Vol 93, Issue 6, p571
- ISSN
0001-6349
- Publication type
Article
- DOI
10.1111/aogs.12412