Admission tests other than cardiotocography for fetal assessment during labour
- PMID: 21678377
- PMCID: PMC6464719
- DOI: 10.1002/14651858.CD008410.pub2
Admission tests other than cardiotocography for fetal assessment during labour
Abstract
Background: Evidence on the benefits of admission tests other than cardiotocography in preventing adverse perinatal outcomes has not been established.
Objectives: To assess the effectiveness of admission tests other than cardiotocography in preventing adverse perinatal outcomes.
Search strategy: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 March 2011).
Selection criteria: Randomised (individual and cluster) controlled trials, comparing labour admission tests other than CTG for the prevention of adverse perinatal outcomes.
Data collection and analysis: Two review authors independently assessed eligibility, quality and extracted data.
Main results: We included one study involving 883 women.Comparison of sonographic assessment of amniotic fluid index (AFI) on admission versus no sonographic assessment of AFI on admission. The incidence of cesarean section for fetal distress in the intervention group (29 of 447) was significantly higher than those of controls (14 of 436) (risk ratio (RR) 2.02; 95% confidence interval (CI) 1.08 to 3.77).The incidence of Apgar score less than seven at five minutes in the intervention group (10 of 447) was not significantly different from controls (seven of 436) (RR 1.39, 95% CI 0.54 to 3.63).The incidence of artificial oxytocin for augmentation of labour in the intervention group (213 of 447) was significantly higher than controls (132 of 436) (RR 1.57; 95% CI 1.32 to 1.87).The incidence of neonatal NICU admission in the intervention group (35 of 447) was not significantly different from the controls (33 of 436) (RR 1.03; 95% CI 0.66 to 1.63)
Authors' conclusions: There is not enough evidence to support the use of admission tests other than cardiotocography for fetal assessment during labour. Appropriate randomised controlled trials with adequate sample size of admission tests other than cardiotocography for fetal assessment during labour are required.
Conflict of interest statement
None known.
Figures




Update of
- doi: 10.1002/14651858.CD008410
References
References to studies included in this review
Chauhan 1995 {published data only}
-
- Chauhan SP, Magann EF, Washburne JF, Perry KG, Martin JN, Morrison JC. Prospective, randomized assessment of amniotic fluid index as a fetal admission test. American Journal of Obstetrics and Gynecology 1994;170:392. - PubMed
-
- Chauhan SP, Washburne JF, Magann EF, Perry KG, Martin JN, Morrison JC. A randomized study to assess the efficacy of the amniotic fluid index as a fetal admission test. Obstetrics & Gynecology 1995;86:9‐13. - PubMed
References to studies excluded from this review
Phelan 1989 {published data only}
-
- Phelan JP, Sarno AP, Ahn MO. The fetal admission test. Proceedings of 37th Annual Clinical Meeting of American College of Obstetricians and Gynecologists; 1989 May 22‐25; Atlanta, Georgia, USA. 1989:4.
Additional references
Alfirevic 2006
Alfirevic 2009
-
- Alfirevic Z, Stampalija T, Gyte GML. Fetal and umbilical Doppler ultrasound in high‐risk pregnancies. Cochrane Database of Systematic Reviews 2009, Issue 1. [DOI: 10.1002/14651858.CD007529] - DOI
Archibong 1999
-
- Archibong EI. Biophysical profile score in late pregnancy and timing of delivery. International Journal of Gynecology & Obstetrics 1999;64(2):129‐33. - PubMed
Blix 2005
-
- Blix E, Reiner LM, Klovning A, Oian P. Prognostic value of the labour admission test and its effectiveness compared with auscultation only: a systematic review. BJOG: an International Journal of Obstetrics and Gynaecology 2005;112:1595‐604. - PubMed
Chauhan 1994
-
- Chauhan SP, Magann EF, Sullivan CA, Lutton PM, Bailey K, Morrison JC. Amniotic fluid index as an admission test may increase the incidence of cesarean section in a community hospital. Journal of Maternal‐Fetal Investigation 1994;4:223‐6.
Costello 1994
Devane 2010
East 2005
Egger 1997
Harbord 2006
-
- Harbord RM, Egger M, Sterne JA. A modified test for small‐study effects in meta‐analyses of controlled trials with binary endpoints. Statistics in Medicine 2006;25:3443‐57. - PubMed
Higgins 2011
-
- Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Ingemarsson 1986
-
- Ingemarsson I, Arulkumaran S, Ingemarsson E, Tambyraja RL, Ratnam SS. Admission test: a screening test for fetal distress in labor. Obstetrics & Gynecology 1986;68:800‐6. - PubMed
Kim 2003
-
- Kim SY, Khandelwal M, Gaughan JP, Agar MH, Reece EA. Is the intrapartum biophysical profile useful?. Obstetrics & Gynecology 2003;102:471‐6. - PubMed
Lalor 2008
Liston 2007
-
- Liston R, Sawchuck D, Young D, Society of Obstetrics and Gynaecologists of Canada, British Columbia Perinatal Health Program. Fetal health surveillance: antepartum and intrapartum consensus guideline. Journal of Obstetrics and Gynaecology Canada 2007;29(9 Suppl 4):S3‐S56. - PubMed
Malcus 1991
-
- Malcus P, Gudmundsson S, Marsal K, Kwok HH, Vengadasalam D, Ratnam SS. Umbilical artery doppler velocimetry as a labor admission test. Obstetrics & Gynecology 1991;77:10‐6. - PubMed
Manning 1980
-
- Manning FA, Platt LD, Sipos L. Antepartum fetal evaluation: development of a new biophysical profile. American Journal of Obstetrics and Gynecology 1980;136:787‐95. - PubMed
Mires 2001
Moses 2004
-
- Moses J, Doherty DA, Magann EF, Chauhan SP, Morrison JC. A randomized clinical trial of the intrapartum assessment of amniotic fluid volume: amniotic fluid index versus the single deepest pocket technique. American Journal of Obstetrics and Gynecology 2004;190:1564‐9. - PubMed
Nabhan 2008
Phelan 1987
-
- Phelan JP, Ahn MO, Smith CV, Rutherford SE, Morrison JC. Amniotic fluid index and adverse outcome. Journal of Reproductive Medicine 1987;32:601‐4. - PubMed
RevMan 2008 [Computer program]
-
- The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.0. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2008.
Sarno 1989
-
- Sarno AP, Ahn MO, Brar HS, Phelan JP, Platt LD. Intrapartum doppler velocimetry, amniotic fluid volume, and fetal heart rate as predictors of subsequent fetal distress: an initial report. American Journal of Obstetrics and Gynecology 1989;161:1508‐4. - PubMed
Sarno 1990
-
- Sarno AP, Ahn MO, Phelan JP, Paul RH. Fetal acoustic stimulation in the early intrapartum period as a predictor of subsequent fetal condition. American Journal of Obstetrics and Gynecology 1990;162:762‐7. - PubMed
Tongprasert 2006
-
- Tongprasert F, Jinpala S, Srisupandit K, Tongsong T. The rapid biophysical profile for early intrapartum fetal well‐being assessment. International Journal of Gynecology & Obstetrics 2006;95:14‐7. - PubMed
Tongsong 1999
-
- Tongsong T, Piyamongkol W, Anantachote A, Pulphutapong K. The rapid biophysical profile for assessment of fetal well‐being. Journal of Obstetrics and Gynaecology Research 1999;25:431‐6. - PubMed
WHO 1997
-
- World Health Organization. The World Health Report 1995. Geneva: World Health Organization, 1997.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical