Summary of findings 5. Intermittent ausculation of fetal heart rate in labour for fetal well‐being ‐ Intensive Pinard versus routine Pinard (outcomes for the baby).
| Intermittent ausculation of fetal heart rate in labour for fetal well‐being ‐ Intensive Pinard versus Routine Pinard (outcomes for the baby) | ||||||
| Patient or population: women in established labour and their babies. Setting: all studies were conducted in Africa (Zimbabwe and Uganda). Intervention: intensive Pinard. 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 Intensive Pinard | |||||
| Apgar < 7 at 5 minutes | 29 per 1000 | 26 per 1000 (10 to 66) | RR 0.90 (0.35 to 2.31) | 625 (1 RCT) | ⊕⊝⊝⊝ VERY LOW 1,2 | Study reported Apgar score < 6 at 5 minutes. |
| Cord blood acidosis | 0 per 1000 | 0 per 1000 (0 to 0) | not estimable | (0 studies) | No data reported for cord blood acidosis in the included studies. | |
| Neonatal seizures | 29 per 1000 | 19 per 1000 (7 to 54) | RR 0.68 (0.24 to 1.88) | 625 (1 RCT) | ⊕⊝⊝⊝ VERY LOW 1,2 | |
| Perinatal mortality | 29 per 1000 | 16 per 1000 (5 to 48) | RR 0.56 (0.19 to 1.67) | 625 (1 RCT) | ⊕⊝⊝⊝ VERY LOW 1,2 | Neonatal deaths included, unable to separate out from reported data. |
| Composite of mortality and serious morbidity | 0 per 1000 | 0 per 1000 (0 to 0) | not estimable | (0 studies) | No data reported for a composite of mortality and serious morbidity in the included studies. | |
| Cerebral palsy | 0 per 1000 | 0 per 1000 (0 to 0) | not estimable | (0 studies) | No data reported for cerebral palsy in the included studies. | |
| Neurosensory disability | 0 per 1000 | 0 per 1000 (0 to 0) | not estimable | (0 studies) | No data reported for neurosensory disability in the included trial. | |
| *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 1 level.
2 Evidence was imprecise; wide 95% CI crossing the line of no effect and low event rate. Downgraded 2 levels.