{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T09:19:45Z","timestamp":1696411185450},"reference-count":15,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,6,14]],"date-time":"2016-06-14T00:00:00Z","timestamp":1465862400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2016,8]]},"abstract":"Background<\/jats:title>Fetal scalp lactate (FSL<\/jats:styled-content>) is used when the cardiotocography (CTG<\/jats:styled-content>) is not normal in an attempt to reduce the false\u2010positive rate and the likelihood of unnecessary intervention. Whilst the test has almost a 100% negative predictive value, the positive predictive value of this test is very low.<\/jats:p><\/jats:sec>Aims<\/jats:title>To measure the effect of introducing consultant obstetrician review of every abnormal CTG<\/jats:styled-content> prior to the decision to\u00a0perform FSL<\/jats:styled-content>.<\/jats:p><\/jats:sec>Materials and Methods<\/jats:title>A retrospective cohort study was performed using routinely collected de\u2010identified data. Mode of birth outcomes for women who had a continuous CTG<\/jats:styled-content> in labour were compared in two equal time periods, 12\u00a0months before and after a change in hospital policy. Change in hospital policy dictated that FSL<\/jats:styled-content> was only performed on a pathological CTG<\/jats:styled-content> after consultant obstetrician review of the CTG<\/jats:styled-content>.<\/jats:p><\/jats:sec>Results<\/jats:title>Consultant obstetrician review of CTG<\/jats:styled-content> prior to FSL<\/jats:styled-content> was associated with fewer FSL<\/jats:styled-content> performed (1.7% vs 3.5%; P<\/jats:italic>\u00a0\u2264\u00a00.01), fewer babies acidaemic at birth pH<\/jats:styled-content>\u00a0<\u00a07.1 (0.8% vs 2.2%; P<\/jats:italic>\u00a0<\u00a00.01), fewer caesarean sections for presumed fetal distress (CS<\/jats:styled-content> for FD<\/jats:styled-content>) (6.6% vs 8.1%; P<\/jats:italic>\u00a0=\u00a00.05) and fewer instrumental births (17.6% vs 20%; P<\/jats:italic>\u00a0=\u00a00.04). When adjusted for confounders, the change in policy was independently associated with a reduced likelihood of CS<\/jats:styled-content> for FD<\/jats:styled-content> (adjusted odds ratios\u00a0=\u00a00.78 (0.63\u20130.97); P<\/jats:italic>\u00a0=\u00a00.03).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>A hospital policy whereby a consultant obstetrician reviews abnormal CTG<\/jats:styled-content>s prior to performing FSL<\/jats:styled-content> may\u00a0help to increase the pretest probability and reduce the rate of CS<\/jats:styled-content> for FD<\/jats:styled-content>, as well as instrumental birth and unnecessary FSL<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.12480","type":"journal-article","created":{"date-parts":[[2016,6,14]],"date-time":"2016-06-14T12:16:50Z","timestamp":1465906610000},"page":"387-390","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Involving the consultant before fetal blood sampling"],"prefix":"10.1111","volume":"56","author":[{"given":"Belinda","family":"Lowe","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Mater Health Services South Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Beckmann","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Mater Health Services South Brisbane Queensland Australia"},{"name":"Mater Research The University of Queensland South Brisbane Queensland Australia"},{"name":"School of Medicine The University of Queensland Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,6,14]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"crossref","DOI":"10.1002\/14651858.CD006066","article-title":"Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour","volume":"3","author":"Alfirevic Z","year":"2006","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_5_3_1","volume-title":"Electronic Fetal Monitoring: The Use and Interpretation of Cardiotography in Intrapartum Fetal Surveillance","author":"Royal College of Obstetricians and Gynaecologists","year":"2001"},{"key":"e_1_2_5_4_1","volume-title":"Intrapartum Fetal Surveillance Clinical Guidelines","author":"Royal Australian and New Zealand College of Obstetricians and Gynaecologists","year":"2014"},{"key":"e_1_2_5_5_1","series-title":"Perinatal Statistics Series. 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Cat no, PER 59","volume-title":"Australia's Mothers and Babies 2011","author":"Li Z"},{"key":"e_1_2_5_6_1","first-page":"1","article-title":"Fetal pulse oximetry for fetal assessment in labour","volume":"2","author":"East CE","year":"2007","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_5_7_1","first-page":"1","article-title":"Fetal electrocardiogram (ECG) for fetal monitoring during labour","volume":"5","author":"Neilson JP","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_5_8_1","article-title":"Fetal vibroacoustic stimulation for stimulation for facilitation of tests of fetal wellbeing","volume":"12","author":"Tan KH","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD002254"},{"key":"e_1_2_5_10_1","first-page":"1","article-title":"Intrapartum fetal scalp lactate sampling in the presence of a non\u2010reassuring fetal heart rate trace","volume":"3","author":"East CE","year":"2010","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.12144"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1999.tb08187.x"},{"key":"e_1_2_5_13_1","doi-asserted-by":"crossref","first-page":"e61476","DOI":"10.1371\/journal.pone.0061476","article-title":"Consultant input in acute medical admissions and patient outcomes in hospitals in England: a multivariate analysis","volume":"8","author":"Bell D","journal-title":"PLoS ONE"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000247721.97008.6F"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c3498"},{"key":"e_1_2_5_16_1","volume-title":"The Future Role of the Consultant","author":"Royal College of Obstetricians and Gynaecologists","year":"2005"}],"container-title":["Australian and New Zealand Journal of Obstetrics and Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fajo.12480","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.12480","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T23:07:55Z","timestamp":1696374475000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/ajo.12480"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,6,14]]},"references-count":15,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2016,8]]}},"alternative-id":["10.1111\/ajo.12480"],"URL":"https:\/\/doi.org\/10.1111\/ajo.12480","archive":["Portico"],"relation":{},"ISSN":["0004-8666","1479-828X"],"issn-type":[{"value":"0004-8666","type":"print"},{"value":"1479-828X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,6,14]]},"assertion":[{"value":"2016-01-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-04-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-06-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}