Summary of findings 2. Intermittent ausculation of fetal heart rate in labour for fetal well‐being ‐ Intermittent electronic fetal monitoring (CTG) versus routine Pinard (outcomes for the mother).
| Intermittent ausculation of fetal heart rate in labour for fetal well‐being ‐ Intermittent electronic fetal monitoring (CTG) (inconsistent/ opportunistic paper tracing) versus Routine Pinard (outcomes for the mother). | ||||||
| Patient or population: women in established labour and their babies. Setting: all studies were conducted in Africa (Zimbawe and Uganda). Intervention: electronic fetal monitoring (CTG) without paper tracing. Comparison: routine Pinard. | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Risk with routine Pinard | Risk with Intermittent electronic fetal monitoring intensive Pinard | |||||
| Caesarean section for fetal distress and/or fetal acidosis | 60 per 1000 | 176 per 1000 (107 to 290) | RR 2.92 (1.78 to 4.80) | 633 (1 RCT) | ⊕⊕⊕⊝ MODERATE 1, | |
| Instrumental vaginal birth | 67 per 1000 | 97 per 1000 (57 to 166) | RR 1.46 (0.86 to 2.49) | 633 (1 RCT) | ⊕⊕⊝⊝ LOW 1,2, | |
| Maternal mortality | 0 per 1000 | 0 per 1000 (0 to 0) | not estimable | (0 studies) | No data reported for maternal mortality in the included studies. | |
| Any pharmacological or non‐pharmacological analgesia use excluding epidural | 0 per 1000 | 0 per 1000 (0 to 0) | not estimable | (0 studies) | No data reported for any pharmacological or non‐ pharmacological analgesia use excluding epidural in the included studies. | |
| Epidural anaesthesia for pain relief excluding for caesarean section | 0 per 1000 | 0 per 1000 (0 to 0) | not estimable | (0 studies) | No data reported for epidural anaesthesia for pain relief excluding for caesarean section in the included studies. However, 1 trial reported that no epidural analgesia was available in the labour ward. | |
| Mobility or restriction during labour | 0 per 1000 | 0 per 1000 (0 to 0) | not estimable | (0 studies) | No data reported for mobility or restriction during labour in the included studies. | |
| Postnatal depression | 0 per 1000 | 0 per 1000 (0 to 0) | not estimable | (0 studies) | No data reported for postnatal depression in the included studies. | |
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio; OR: Odds ratio; | ||||||
| GRADE Working Group grades of evidence High quality: we are very confident that the true effect lies close to that of the estimate of the effect Moderate quality: we are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low quality: our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low quality: we have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect | ||||||
1 Blinding of participants and health professionals not possible; high risk of performance bias and it is unclear if outcome assessors were blinded. Downgraded one level.
2 Evidence of imprecision with wide confidence intervals. Downgraded one level.