Computerised interpretation of fetal heart rate during labour (INFANT): a randomised controlled trial
| العنوان: | Computerised interpretation of fetal heart rate during labour (INFANT): a randomised controlled trial |
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| المؤلفون: | Brocklehurst, P., Johns, N., Johnston, T., Barnfield, G., Davies, K., Johnson, M., Patterson, H., Montague, I., Watmore, S., Stolton, A., Parisaei, M., McGhee, N., Segovia, S., Martindale, E., Jackson, H., Holleran, J., Roberts, D., Holt, S., Dragovic, B., Willmott-Powell, M., Hutchinson, L., Toth, B., Chandler, G., Ridley, S., Bugg, G., Molnar, A., Lochrie, D., Connor, J., Howe, D., Head, K., Wellstead, S., Mathers, A., Walker, L., Crawford, I., Davies, D., Garner, Z., Galloway, L., Davies, Y., Smith, C., Perkins, G., Geary, M., Walsh, F., Nagle, U., O'Malley, L., Katakam, N., White, H., Tanton, E., Hamilton, R., Glanowski, H., Forde, E., MacDonald, C., Mckay, L., Edoziern, L., Doran, P., Dillon, J., Taylor, C., Evans, P., Miller, V., Wayne, C., Tebbutt, J., Hendy, E., O'Brien, P., Subair, S., Dent, H., Mallet, C., Quenby, S., Hillen, J., Young, P., Harrison, T., Wood, L., Arya, R., Roughley, L., Sorinola, O., Rogers, C., Phipps, J., Plachcinski, R., Grp, INFANT Collaborative |
| المساهمون: | The INFANT Collaborative Group, Juszczak, Ed |
| المصدر: | Lancet (London, England) |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | Adult, Pediatrics, medicine.medical_specialty, Cardiotocography, Encephalopathy, Gestational Age, law.invention, Decision Support Techniques, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Pregnancy, Surveys and Questionnaires, medicine, Humans, 030212 general & internal medicine, Twin Pregnancy, Medicine(all), Asphyxia, 030219 obstetrics & reproductive medicine, Intention-to-treat analysis, Labor, Obstetric, Obstetrics, business.industry, Neonatal encephalopathy, Incidence (epidemiology), Infant, Newborn, Pregnancy Outcome, Obstetrics and Gynecology, Signal Processing, Computer-Assisted, General Medicine, Articles, Heart Rate, Fetal, medicine.disease, Delivery, Obstetric, R1, Gynecology, Relative risk, Gestation, Female, RG, medicine.symptom, business |
| الوصف: | © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license Background Continuous electronic fetal heart-rate monitoring is widely used during labour, and computerised interpretation could increase its usefulness. We aimed to establish whether the addition of decision-support software to assist in the interpretation of cardiotocographs affected the number of poor neonatal outcomes. Methods In this unmasked randomised controlled trial, we recruited women in labour aged 16 years or older having continuous electronic fetal monitoring, with a singleton or twin pregnancy, and at 35 weeks' gestation or more at 24 maternity units in the UK and Ireland. They were randomly assigned (1:1) to decision support with the INFANT system or no decision support via a computer-generated stratified block randomisation schedule. The primary outcomes were poor neonatal outcome (intrapartum stillbirth or early neonatal death excluding lethal congenital anomalies, or neonatal encephalopathy, admission to the neonatal unit within 24 h for ≥48 h with evidence of feeding difficulties, respiratory illness, or encephalopathy with evidence of compromise at birth), and developmental assessment at age 2 years in a subset of surviving children. Analyses were done by intention to treat. This trial is completed and is registered with the ISRCTN Registry, number 98680152. Findings Between Jan 6, 2010, and Aug 31, 2013, 47 062 women were randomly assigned (23 515 in the decision-support group and 23 547 in the no-decision-support group) and 46 042 were analysed (22 987 in the decision-support group and 23 055 in the no-decision-support group). We noted no difference in the incidence of poor neonatal outcome between the groups—172 (0·7%) babies in the decision-support group compared with 171 (0·7%) babies in the no-decision-support group (adjusted risk ratio 1·01, 95% CI 0·82–1·25). At 2 years, no significant differences were noted in terms of developmental assessment. Interpretation Use of computerised interpretation of cardiotocographs in women who have continuous electronic fetal monitoring in labour does not improve clinical outcomes for mothers or babies. Funding National Institute for Health Research. |
| وصف الملف: | application/pdf; PDF |
| تدمد: | 1474-547X 0140-6736 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0dad75f70829a09abbba7310ff1dac69Test https://pubmed.ncbi.nlm.nih.gov/31486222Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....0dad75f70829a09abbba7310ff1dac69 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 1474547X 01406736 |
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