A case–control study of the interaction of fetal heart rate abnormalities, fetal growth restriction, meconium in the amniotic fluid and tachysystole, in relation to the outcome of labour

Objective To quantify the incidence of intrapartum risk factors in labours with an adverse outcome, and compare them with the incidence of the same indicators in a series of consecutive labours without adverse outcome. Design Case–control study. Setting Twenty‐six maternity units in the UK. Populati...

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Bibliographic Details
Published in:BJOG : an international journal of obstetrics and gynaecology 2023-02, Vol.130 (3), p.286-291
Main Authors: Steer, Philip J., Yau, Christopher W. H., Blott, Maggie, Lattey, Katherine, Nwandison, Millicent, Uddin, Zeenath, Winter, Cathy, Draycott, Timothy
Format: Article
Language:English
Subjects:
Amniotic Fluid
Case-Control Studies
Childbirth & labor
Clinical outcomes
Female
fetal compromise
Fetal Distress
Fetal Growth Retardation
Fetuses
Health risks
Heart rate
Heart Rate, Fetal - physiology
Humans
Infant, Newborn
labour outcome
Meconium
Pregnancy
Risk assessment
Risk factors
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Summary:Objective To quantify the incidence of intrapartum risk factors in labours with an adverse outcome, and compare them with the incidence of the same indicators in a series of consecutive labours without adverse outcome. Design Case–control study. Setting Twenty‐six maternity units in the UK. Population or sample Sixty‐nine labours with an adverse outcome and 198 labours without adverse outcome. Methods Observational study. Main outcome measures Incidence of risk factors in hourly assessments for 7 hours before birth in the two groups. Results A risk score combining suspected fetal growth restriction, tachysystole, meconium in the amniotic fluid and fetal heart rate abnormalities (baseline rate and variability, presence of decelerations) gave the best indication of likely outcome group. Conclusions Accurate risk assessment in labour requires fetal heart rate abnormalities to be considered in context with additional intrapartum risk factors.
ISSN:1470-0328
1471-0528
DOI:10.1111/1471-0528.17302