{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T02:12:44Z","timestamp":1792289564494,"version":"4.4.0"},"reference-count":13,"publisher":"BMJ","issue":"6927","license":[{"start":{"date-parts":[[1994,2,19]],"date-time":"1994-02-19T00:00:00Z","timestamp":761616000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ"],"accepted":{"date-parts":[[1993,11,1]]},"published-print":{"date-parts":[[1994,2,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Objective<\/jats:bold>\n                    : To compare effectiveness of different methods of monitoring intrapartum fetal heart rate.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Design<\/jats:bold>\n                    : Prospective randomised controlled trial.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Setting<\/jats:bold>\n                    : Referral maternity hospital, Harare,Zimbabwe.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Subjects<\/jats:bold>\n                    : 1255 women who were 37 weeks or more pregnant with singleton cephalic presentation and normal fetal heart rate before entry into study.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Interventions<\/jats:bold>\n                    : Intermittent monitoring of fetal heart rate by electronic monitoring, Doppler ultrasound, use of Pinard stethoscope by a research midwife, or routine use of Pinard stethoscope by attending midwife. Main outcome measures - Abnormal fetal heart rate patterns, need for operative delivery for fetal distress, neonatal mortality, Apgar scores, admission to neonatal unit, neonatal seizures, and hypoxic ischaemic encephalopathy.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results<\/jats:bold>\n                    : Abnormalities in fetal heart rate were detected in 54% (172\/318) of the electronic monitoring group, 32% (100\/312) of the ultrasonography group, 15% (47\/310) of the Pinard stethoscope group, and 9% (28\/315) of the routine monitoring group. Caesarean sections were performed for 28% (89), 24% (76), 10% (32), and 15% (46) of the four groups respectively. Neonatal outcome was best in the ultrasonography group: hypoxic ischaemic encephalopathy occurred in two, one, seven, and 10 cases in the four groups respectively; neonatal seizures occurred only in the last two groups (six and nine cases respectively); and deaths occurred in eight,two, five, and nine cases respectively.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions<\/jats:bold>\n                    : Abnormalities in fetal heart rate were more reliably detected by Doppler ultrasonography than with Pinard stethoscope, and its use resulted in good perinatal outcome. The use ofrelatively cheap ultrasound monitors should be further evaluated and promoted in obstetric units caring for high risk pregnancies in developing countries with scarce resources.\n                  <\/jats:p>","DOI":"10.1136\/bmj.308.6927.497","type":"journal-article","created":{"date-parts":[[2011,10,27]],"date-time":"2011-10-27T19:20:09Z","timestamp":1319743209000},"page":"497-500","source":"Crossref","is-referenced-by-count":69,"title":["Randomised controlled trial of intrapartum fetal heart rate monitoring"],"prefix":"10.1136","volume":"308","author":[{"given":"K","family":"Mahomed","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Nyoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"Mulambo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Kasule","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Jacobus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1994,2,19]]},"reference":[{"key":"2025122309345895000_308.6927.497.1","first-page":"715","article-title":"Interrelationships among abnormal cardiotocograms in labour, meconium staining of the amniotic fluid, arterial cord blood pH, and Apgar scores","volume":"74","author":"Steer","year":"1989","journal-title":"Obstet Gynecol"},{"key":"2025122309345895000_308.6927.497.2","first-page":"846","article-title":"Monitoring the fetus during labour","volume-title":"Effective care in pregnancy and childbirth","volume":"2","author":"Grant","year":"1989"},{"key":"2025122309345895000_308.6927.497.3","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1016\/0002-9378(76)90565-2","article-title":"The evaluation of continuous fetal heart rate monitoring in high risk pregnancy","volume":"125","author":"Haverkamp","year":"1986","journal-title":"Am J Obstet Gynecol"},{"key":"2025122309345895000_308.6927.497.4","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1016\/0002-9378(76)90641-4","article-title":"Controlled trial of fetal intensive care","volume":"126","author":"Renou","year":"1976","journal-title":"Am J Obstet Gynecol"},{"key":"2025122309345895000_308.6927.497.5","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/S0002-9378(16)33082-4","article-title":"A controlled trial of the differential effect of interpartum fetal monitoring","volume":"134","author":"Haverkamp","year":"1979","journal-title":"Am J Obstet Gynecol"},{"key":"2025122309345895000_308.6927.497.6","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1016\/0002-9378(85)90619-2","article-title":"The Dublin randomised trial of intrapartum fetal heart monitoring","volume":"152","author":"MacDonald","year":"1985","journal-title":"Am J Obstet Gynecol"},{"key":"2025122309345895000_308.6927.497.7","first-page":"379","article-title":"Limitations of current fetal monitoring techniques","volume":"14","author":"Crawford","year":"1986","journal-title":"J Perinat Med"},{"key":"2025122309345895000_308.6927.497.8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-536X.1985.tb00943.x"},{"key":"2025122309345895000_308.6927.497.9","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1111\/j.1471-0528.1972.tb14207.x","article-title":"Cervicographs in the management of labour on primigravidae. I: The alert line for detecting abnormal labour","volume":"79","author":"Philpott","year":"1972","journal-title":"J Obstet Gynaecol Br Commnw"},{"key":"2025122309345895000_308.6927.497.10","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1111\/j.1471-0528.1972.tb14208.x","article-title":"Cervicographs in the management of labour in primigravidae. II: The action line and treatment of abnormal labour","volume":"79","author":"Philpott","year":"1972","journal-title":"J Obstet Gynaecol Br Commnw"},{"key":"2025122309345895000_308.6927.497.11","first-page":"127","article-title":"Appropriate technology in intrapartum fetal surveillance","volume-title":"Progress in obstetrics and gynaecology","volume":"8","author":"Arulkumaran","year":"1990"},{"key":"2025122309345895000_308.6927.497.12","unstructured":"Chalmers I .Randomised controlled trials in intrapartum monitoring. In: Thalhammer O Baumgarten KV Polak A eds.Perinatal medicine.Stuttgart: Georg Thieme,1979: 260\u20135."},{"key":"2025122309345895000_308.6927.497.13","doi-asserted-by":"crossref","unstructured":"Sarnat HB Sarnat MS .Potential new therapies for perinatal cerebral hypoxic ischaemia. In: Sankaran S ed.Clinics in perinatology.Philadelphia: W B Saunders,1993:411.","DOI":"10.1016\/S0095-5108(18)30401-9"}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj.308.6927.497","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj.308.6927.497","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T17:35:07Z","timestamp":1766511307000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj.308.6927.497"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1994,2,19]]},"references-count":13,"journal-issue":{"issue":"6927","published-online":{"date-parts":[[1994,2,19]]},"published-print":{"date-parts":[[1994,2,19]]}},"alternative-id":["10.1136\/bmj.308.6927.497"],"URL":"https:\/\/doi.org\/10.1136\/bmj.308.6927.497","relation":{},"ISSN":["0959-8138","1468-5833"],"issn-type":[{"value":"0959-8138","type":"print"},{"value":"1468-5833","type":"electronic"}],"subject":[],"published":{"date-parts":[[1994,2,19]]}}}