Paschal F Mdoe1,2, Hege L Ersdal3,4, Estomih Mduma1,4, Robert Moshiro2,5, Ingvild Dalen4, Jeffrey M Perlman6, Hussein Kidanto4,7. 1. Haydom Lutheran Hospital, Mbulu, Tanzania. 2. Department of Health Science, University of Stavanger, Stavanger, Norway. 3. Department of Anesthesiology and Intensive Care, Stavanger University Hospital, Stavanger, Norway. 4. Department of Research, Stavanger University Hospital, Stavanger, Norway. 5. Muhimbili National Hospital, Dar es Salaam, Tanzania. 6. Department of Pediatrics, Weill Cornell, New York, NY, USA. 7. Aga Khan University, Dar es Salaam, Tanzania.
Abstract
OBJECTIVE: To compare the frequency of abnormal fetal heart rate (FHR) detection between continuous Doppler and intermittent fetoscope monitoring. METHOD: A randomized controlled open-label trial was conducted between February 1, 2016, and January 31, 2017, at Haydom Lutheran hospital, Tanzania. Women in active labor with singleton pregnancies and normal FHR at admission were randomly allocated in a 1:1 ratio to receive either continuous or intermittent FHR monitoring. The primary outcome was abnormal FHR detection. RESULTS:2652 women were enrolled; 1340 receivedcontinuous monitoring and 1312 received intermittent monitoring. Continuous FHR monitoring detected abnormal FHR in 108 (8.1%) participants versus 40 (3.0%) participants in the intermittent monitoring group (risk ratio [RR] 2.64, 95% confidence interval [CI] 1.8-3.7; P<0.001). The increased detection rate in the continuous versus intermittent monitoring group was associated with an increase in rate of subsequent intrauterine resuscitations (89 [6.6%] vs 42 [3.2%]; RR 2.07, 95% CI 1.4-2.9; P<0.001). In total, 92 (3.5%) infants had adverse perinatal outcomes, with no significant differences between groups. CONCLUSION: Continuous FHR monitoring increased identification of abnormal FHR and subsequent intrauterine resuscitations. ClinicalTrials.gov: NCT02790814.
RCT Entities:
OBJECTIVE: To compare the frequency of abnormal fetal heart rate (FHR) detection between continuous Doppler and intermittent fetoscope monitoring. METHOD: A randomized controlled open-label trial was conducted between February 1, 2016, and January 31, 2017, at Haydom Lutheran hospital, Tanzania. Women in active labor with singleton pregnancies and normal FHR at admission were randomly allocated in a 1:1 ratio to receive either continuous or intermittent FHR monitoring. The primary outcome was abnormal FHR detection. RESULTS: 2652 women were enrolled; 1340 received continuous monitoring and 1312 received intermittent monitoring. Continuous FHR monitoring detected abnormal FHR in 108 (8.1%) participants versus 40 (3.0%) participants in the intermittent monitoring group (risk ratio [RR] 2.64, 95% confidence interval [CI] 1.8-3.7; P<0.001). The increased detection rate in the continuous versus intermittent monitoring group was associated with an increase in rate of subsequent intrauterine resuscitations (89 [6.6%] vs 42 [3.2%]; RR 2.07, 95% CI 1.4-2.9; P<0.001). In total, 92 (3.5%) infants had adverse perinatal outcomes, with no significant differences between groups. CONCLUSION: Continuous FHR monitoring increased identification of abnormal FHR and subsequent intrauterine resuscitations. ClinicalTrials.gov: NCT02790814.
Authors: Benjamin Kamala; Hussein Kidanto; Ingvild Dalen; Matilda Ngarina; Muzdalifat Abeid; Jeffrey Perlman; Hege Ersdal Journal: Int J Environ Res Public Health Date: 2019-01-24 Impact factor: 3.390
Authors: Robert Moshiro; Jeffrey M Perlman; Paschal Mdoe; Hussein Kidanto; Jan Terje Kvaløy; Hege L Ersdal Journal: PLoS One Date: 2019-10-02 Impact factor: 3.240
Authors: Benjamin A Kamala; Hege L Ersdal; Ingvild Dalen; Muzdalifat S Abeid; Matilda M Ngarina; Jeffrey M Perlman; Hussein L Kidanto Journal: PLoS One Date: 2018-10-11 Impact factor: 3.240
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