From: Reducing stillbirths: screening and monitoring during pregnancy and labour
Source | Location and Type of Study | Intervention | Stillbirths/Perinatal Outcomes |
---|---|---|---|
Reviews and meta-analyses | |||
Pattison and McCowan 1999 [91] | UK, Australia. Review (Cochrane). 3 RCTs included (N = 1279). | Compared the impact of electronic fetal monitoring with an antenatal CTG (intervention) vs. a control group where the results of the CTG were withheld from the caregiver or no monitoring was done on perinatal morbidity and mortality and maternal morbidity. | PMR (excluding lethal abnormalities): OR = 2.65 (95% CI: 0.99–7.12) [NS]. [12/651 vs. 4/628 in intervention and control groups, respectively]. |
Observational studies | |||
Evertson et al. 1978 [90] | USA. Case series. N = 746 pregnant women undergoing 1119 CSTs. | Assessed the incidence of fetal deaths within one week of a negative CST. | SBR: 7/680 patients (1%) within 1 week of a negative CST. Fetal death in most cases resulted from factors other then uteroplacental insufficiency (umbilical cord accident, malformations, and placental abruption) |
Flynn et al. 1982 [88] | UK. RCT. Pregnant patients (N = 300) with non-stress antepartum cardiotocography tracings (N = 569; N = 144 intervention, N = 156 controls). | Compared impact on pregnancy outcomes of revealing cardiotocography results to clinician (intervention) vs. concealing results (controls). | SBR+NMR: Significant association with 'non-reactive' traces. Significant association of nonreactive traces with rates of fetal growth restriction, admission to special care baby unit, Apgar scores at 1 and 5 min. |
Freeman et al. 1982 [92] | USA and Canada. 18 institutions. Comparison of diagnostic tests. Pregnant women (N = 6168; N = 4626 CST, N = 1542 NST) with increased risk for uteroplacental insufficiency. | Compared the impact on fetal outcomes of CST (intervention) vs. NST (comparison) for primary fetal surveillance. | PMR: 8.4/1000 vs. 21.4/1000 in intervention vs. comparison groups, respectively (P < 0.05). After correction for congenital anomalies and unrelated causes: 3.5/1000 vs. 7.1/1000 intervention vs. comparison groups, respectively (P < 0.05). Fetal death (miscarriage+SB): 1.1/1000 vs. 7.8/1000 in intervention vs. comparison groups, respectively (P < 0.05). After correction: 0.4/1000 vs. 3.2/1000 in intervention vs. comparison groups, respectively (P < 0.05). |
Rayburn et al. 1980 [89] | USA (Lexington). University hospital. Prospective cohort study. High-risk clinic patients (N = 561) who had undergone NST within one week prior to delivery. | Compared the association of reactive vs. non-reactive NSTs vs. no testing with fetal outcomes. | SB: 1/509 in reactive non-stress group (cord accident). Corrected PMR: 1/509 vs. 2/22 vs. 20/1000 in reactive, non-reactive and no testing groups, respectively (P < 0.05). Fetal compromise: 4%, 36%, and 13% in reactive, non-reactive and no testing groups, respectively (P < 0.001) |