{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T08:19:53Z","timestamp":1771229993909,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T00:00:00Z","timestamp":1736380800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T00:00:00Z","timestamp":1736380800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2025,4]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n To establish whether digital foetal scalp stimulation (dFSS) performs better than foetal blood sampling (FBS) in terms of reducing the rate of caesarean section (CS) in labour, without adversely affecting perinatal outcomes.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n A multicentre parallel\u2010group randomised controlled trial.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Maternity centres in Ireland.<\/jats:p>\n <\/jats:sec>\n \n Population<\/jats:title>\n The study aimed to randomise 2500 nulliparous women who required a second\u2010line test of foetal well\u2010being in labour due to abnormal cardiotocography (CTG).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Participants were randomly allocated to dFSS or FBS in a 1:1 ratio. Analysis was according to the published protocol and included a meta\u2010analysis of the pilot study data and trial data.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measures<\/jats:title>\n The primary outcome was CS.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Due to lower\u2010than\u2010expected randomisations, the trial concluded early. Of 534 consented participants, 124 had a second\u2010line test of foetal well\u2010being in labour and 43 (34.7%) were randomised; 20 to dFSS and 23 to FBS. The rate of CS was 40.0% (8\/20) in the dFSS group and 47.8% (11\/23) in the FBS group (absolute difference 7.8%; OR 0.73, 95% CI 0.22\u20132.44). The rate of CS was lower in the dFSS group when the trial data were included in a meta\u2010analysis with the pilot data (\n n<\/jats:italic>\n \u2009=\u200950), although the confidence limits were wide (OR 0.41, 95% CI 0.17\u20130.96). There was no significant difference in rates of adverse perinatal and maternal outcomes. Of the nonrandomised participants who received a second\u2010line test, 65% (53\/81) received dFSS.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The small sample size limits the ability to conclude whether dFSS performs better as a second\u2010line test of foetal well\u2010being in labour than FBS. A clinician preference for dFSS was apparent, even though robust evidence is lacking.<\/jats:p>\n \n Trial Registration:<\/jats:bold>\n This trial was prospectively registered on\n ClinicalTrials.gov<\/jats:ext-link>\n on the 31st of March 2022.\n ClinicalTrials.gov<\/jats:ext-link>\n Identifier: NCT05306756 (Access at\n https:\/\/clinicaltrials.gov\/study\/NCT05306756?cond=fetal%20blood%20sampling&rank=3<\/jats:ext-link>\n )\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/1471-0528.18068","type":"journal-article","created":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T03:21:46Z","timestamp":1736392906000},"page":"557-564","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Digital Foetal Scalp Stimulation Versus Foetal Blood Sampling to Assess Foetal Well\u2010Being in Labour: A Multicentre Randomised Controlled Trial"],"prefix":"10.1111","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7892-8333","authenticated-orcid":false,"given":"Sahr","family":"Yambasu","sequence":"first","affiliation":[{"name":"Academic Department of Obstetrics and Gynaecology, The Coombe Hospital & Trinity College University of Dublin Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fiona","family":"Boland","sequence":"additional","affiliation":[{"name":"Data Science Centre and the Department of General Practice RCSI Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keelin","family":"O'Donoghue","sequence":"additional","affiliation":[{"name":"Pregnancy Loss Research Group, Department of Obstetrics & Gynecology University College Cork Cork Ireland"},{"name":"INFANT Research Centre University College Cork Cork Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colleen","family":"Curran","sequence":"additional","affiliation":[{"name":"INFANT Research Centre University College Cork Cork Ireland"},{"name":"Department of Obstetrics & Gynecology University College Cork Cork Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yulia","family":"Shahabuddin","sequence":"additional","affiliation":[{"name":"Academic Department of Obstetrics and Gynaecology, The Coombe Hospital & Trinity College University of Dublin Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda","family":"Cotter","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Limerick Limerick Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geraldine","family":"Gaffney","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Galway Galway Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Declan","family":"Devane","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery, HRB\u2010Trials Methodology Research Network, Evidence Synthesis Ireland and Cochrane Ireland University of Galway Galway Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleanor J.","family":"Molloy","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Trinity College Dublin Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6074-6718","authenticated-orcid":false,"given":"Deirdre J.","family":"Murphy","sequence":"additional","affiliation":[{"name":"Academic Department of Obstetrics and Gynaecology, The Coombe Hospital & Trinity College University of Dublin Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,1,9]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Health Service Executive National Women and Infants Health Programme \u201cNational Clinical Guideline for Fetal Heart Rate Monitoring: Ireland \u201d2021 https:\/\/www.hse.ie\/eng\/about\/who\/acute\u2010hospitals\u2010division\/woman\u2010infants\/clinical\u2010guidelines\/national\u2010clinical\u2010guideline\u2010for\u2010intrapartum\u2010fetal\u2010heart\u2010rate\u2010monitoring\u20102021\u2010.pdf."},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181aef106"},{"key":"e_1_2_9_4_1","unstructured":"National Institute for Health and Care Excellence \u201cFetal Monitoring in Labour: NG229 \u201d2022 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