PubMed · 7931997
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G H Visser. 1994. Why does perinatal morbidity increase.. https://doi.org/10.1515/jpme.1994.22.s1.28
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Fetal heart rate monitoring was introduced in the 1960s. After a number of randomized controlled trials in the mid 1980s, doubt arose regarding the efficacy of fetal heart rate monitoring in improving fetal outcome. The potential reasons why fetal heart rate monitoring has not been shown to be efficacious are (1) use of an outcome measure that is not related to variant fetal heart rate monitoring patterns, (2) lack of standardized interpretation of fetal heart rate patterns, (3) disagreement regarding algorithms for intervention of specific fetal heart rate patterns, and (4) the inability to demonstrate the reliability, validity, and ability of fetal heart rate monitoring to allow timely intervention. A recent National Institutes of Health committee proposed detailed, quantitative, standardized definitions of fetal heart rate patterns, which can serve as a basis for determining whether fetal heart rate monitoring is reliable and valid. In this article we examine reasons why fetal heart rate monitoring did not live up to its original expectations and why the randomized controlled trials did not demonstrate efficacy, and we make suggestions for determining whether electronic fetal heart rate monitoring should be abandoned.
OBJECTIVE: We studied the role of sonography in the management of 370 breech presentations > or = 34 weeks maturity. METHOD: 185 cases had sonographic confirmation of breech presentation prior to the delivery at the Korle Bu Teaching Hospital. A control group of 185 cases did not have prior scanning. RESULTS: Significantly more elective cesarean sections were done in the study group, while the control group had more emergency sections (P = 0.008), and had more traumatic delivery. Birth asphyxia and perinatal mortality were significantly more common in the control group (P < 0.05). CONCLUSION: Sonography done before delivery improved neonatal outcome in breech presentation > or = 34 weeks maturity.
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