



@article {2225,
	title = {Knowledge of adverse neonatal outcome alters clinicians{\textquoteright} interpretation of the intrapartum cardiotocograph},
	journal = {BJOG: An International Journal of Obstetrics and GynaecologyBJOG Int. J. Obstet. Gynaecol.},
	volume = {118},
	year = {2011},
	note = {Cited By (since 1996): 2Export Date: 21 November 2012Source: ScopusCODEN: BIOGFdoi: 10.1111/j.1471-0528.2011.03003.xPubMed ID: 21609381Language of Original Document: EnglishCorrespondence Address: Ayres-de-Campos, D.; Departmento de Ginecologia e Obstetr{\'\i}cia, Faculdade de Medicina do Porto, 4200-309 Porto, Portugal; email: dcampos@med.up.ptReferences: (2006) Perinatal Mortality Surveillance 2004: England, Wales and Northern Ireland, , CEMACH - Centre for Maternal and Child Enquiries (previously Confidential Enquiries into Maternal and Child Health). London: CEMACH;(1997) CESDI - Confidential Enquiry into Stillbirths and Deaths in Infancy, , 4th Annual Report. London: CESDI; 
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},
	month = {2011///},
	pages = {978 - 983},
	abstract = {Objective: To evaluate the impact of knowledge of neonatal outcome on clinicians{\textquoteright} interpretation of the intrapartum cardiotocograph (CTG). Design: Prospective evaluation of pre-recorded cases. Setting: Five maternity hospitals. Population: From a database of intrapartum CTGs acquired with a scalp electrode in singleton near-term fetuses, 20 tracings were sequentially selected from cases with newborn umbilical artery pH < 7.05 and 20 from cases with pH > 7.20. Methods: Five experienced obstetricians practising in different maternity hospitals were asked to analyse the 40 tracings individually, according to the International Federation of Gynaecology and Obstetrics guidelines. In a first round, clinicians were given no information on neonatal outcome. In a second round, carried out 2 months later, clinicians were asked to analyse the same tracings, but the order was randomly altered and information on the newborn{\textquoteright}s arterial pH was provided. Clinicians were not informed of the purpose of the study or whether the tracings were the same. Main outcome measures: The incidence of individual fetal heart rate feature identification and tracing classification, before and after neonatal outcome was made available. Results: In the group with pH < 7.05, repetitive decelerations and reduced variability were more common in the second round (P < 0.001 and P = 0.001, respectively), as was a pathological classification (P = 0.002); variable decelerations were less common (P = 0.008). In the group with normal pH, less tracings in the second round had prolonged decelerations (P = 0.013) and no accelerations (P = 0.013), but more had pronounced decelerations (P = 0.031) and reduced variability (P = 0.007); there was a reduction in pathological classifications, but this difference failed to reach statistical significance (P = 0.051). Conclusions: A knowledge of adverse neonatal outcome leads to a more severe classification of the intrapartum CTG, which derives mainly from the evaluation of decelerations and variability. {\textcopyright} 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology {\textcopyright} 2011 RCOG.},
	keywords = {adverse outcome, Agreement, article, bradycardia, Cardiotocography, clinical competence, Female, Fetal, Fetal hypoxia, Fetal monitoring, fetus heart rate, fetus outcome, health practitioner, Heart rate, Heart Rate, Fetal, human, Humans, Hydrogen-Ion Concentration, incidence, Infant, Newborn, intrapartum care, Labor, Obstetric, medical practice, pH, practice guideline, Practice Guidelines as Topic, Pregnancy, Pregnancy Outcome, priority journal, Prospective Studies, Questionnaires, Reference Standards, Reproducibility of Results, Research Design, Risk Factors, Sweden, tachycardia, umbilical artery},
	isbn = {14700328 (ISSN)},
	url = {http://www.scopus.com/inward/record.url?eid=2-s2.0-79959836242\&partnerID=40\&md5=6b43f72dfcfa8829dfc5395ed140ab7b},
	author = {Ayres-de-Campos, D. and Arteiro, D. and Costa-Santos, C. and Bernardes, J.}
}
