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Prognostic value of the labour admission test and its effectiveness compared with auscultation only: a systematic review.
Nordic Council of Ministers, Nordic School of Public Health NHV. Nordic School of Public Health NHV.
2005 (English)In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 112, no 12, 1595-604 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To assess the effectiveness of the labour admission test in preventing adverse outcomes, compared with auscultation only, and to assess the test's prognostic value in predicting adverse outcomes.

DESIGN: Systematic review.

SETTING: Labour wards in hospitals.

POPULATION: Pregnant women in labour. Three randomised controlled trials including 11,259 women and 11 observational studies including 5831 women.

METHODS: Literature searches in Medline, EMBASE, CINAHL, SweMed, The Cochrane Central Register of Controlled Trials, reference lists from identified studies and contact with experts.

MAIN OUTCOME MEASURES: Obstetric interventions (augmentation of labour, continuous electronic fetal monitoring, epidural analgesia, fetal blood sampling and operative deliveries) and neonatal outcomes (perinatal mortality, Apgar score, seizures, resuscitation and admission to neonatal unit).

RESULTS: Meta-analyses of the controlled trials found that women randomised to the labour admission test were more likely to have minor obstetric interventions like epidural analgesia [relative risk (RR) 1.2, 95% confidence interval (95% CI) 1.1-1.4], continuous electronic fetal monitoring (RR 1.3, 95% CI 1.2-1.5) and fetal blood sampling (RR 1.3, 95% CI 1.1-1.5) compared with women randomised to auscultation on admission. There were no significant differences in any of the other outcomes. From the observational studies, prognostic value for various outcomes was found to be generally poor. Likelihood ratio (LR) for a positive test was above 10 in 2 of 28 single outcomes and between 5 and 10 in six outcomes.

CONCLUSIONS: There is no evidence supporting that the labour admission test is beneficial in low risk women.

Place, publisher, year, edition, pages
2005. Vol. 112, no 12, 1595-604 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:norden:org:diva-3391DOI: 10.1111/j.1471-0528.2005.00766.xPubMedID: 16305561OAI: oai:DiVA.org:norden-3391DiVA: diva2:747919
Available from: 2014-09-17 Created: 2014-09-17 Last updated: 2014-10-09Bibliographically approved
In thesis
1. INNKOMST-CTG. En vurdering av testens prediktive verdier, reliabilitet og effekt: Betydning for jordmødre i deres daglige arbeid
Open this publication in new window or tab >>INNKOMST-CTG. En vurdering av testens prediktive verdier, reliabilitet og effekt: Betydning for jordmødre i deres daglige arbeid
2006 (Norwegian)Doctoral thesis, comprehensive summary (Other academic)
Place, publisher, year, edition, pages
Göteborg: Nordic School of Public Health NHV Göteborg, Sweden, 2006. 93 p.
Series
NHV Reports and Doctor of Public Health-Theses, ISSN 0283-1961 ; Report 2006:3
Keyword
Cardiotocography, Labour, Admission Test, Screening, Inter-Observer Agreement, Systematic review, Midwifery Practice, Kardiotokografi, Inkomst-CTG, Screening, Prediktive Verdier, Inter-Observatør Enighet, Kappa, Jordemorpraksis
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:norden:org:diva-3393 (URN)91-7997-149-0 (ISBN)
Public defence
2006-12-19, Nordic School of Public Health NHV, Göteborg, Sweden, 13:00 (Norwegian)
Opponent
Supervisors
Available from: 2014-09-18 Created: 2014-09-18 Last updated: 2014-09-18Bibliographically approved

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