Does centralized monitoring affect perinatal outcome?

A retrospective study was performed comparing centralized monitoring to noncentralized monitoring in regard to perinatal outcome. The study was conducted at Lehigh Valley Hospital (Allentown, PA) between August 1994 and February 1995. All deliveries during a 28‐week‐period were studied retrospective...

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Bibliographic Details
Published in:The Journal of maternal-fetal medicine 1997-11, Vol.6 (6), p.317-319
Main Authors: Weiss, Patrice M., Balducci, James, Reed, James, Klasko, Stephen K., Rust, Orion A.
Format: Article
Language:English
Subjects:
Apgar Score
centralized monitoring
Cesarean Section
cesarean section rate
Delivery, Obstetric
Female
Fetal Blood
Fetal Monitoring - methods
Heart Rate, Fetal
Humans
Hydrogen-Ion Concentration
Infant Mortality
Infant, Newborn
Intensive Care, Neonatal
perinatal outcome
Pregnancy
Pregnancy Outcome
Retrospective Studies
Vaginal Birth after Cesarean
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Summary:A retrospective study was performed comparing centralized monitoring to noncentralized monitoring in regard to perinatal outcome. The study was conducted at Lehigh Valley Hospital (Allentown, PA) between August 1994 and February 1995. All deliveries during a 28‐week‐period were studied retrospectively. The study was designed such that for 14 weeks all patients were centrally monitored (Group A). During the following 14 weeks, no patients were centrally monitored (Group B). Patients not requiring monitoring, such as elective cesarean sections, were excluded from the study. The variables that were studied were the 5‐minute Apgar, cord blood pH, perinatal mortality, admissions to the neonatal intensive care unit (NICU), spontaneous vaginal deliveries, cesarean sections, and operative vaginal deliveries. A total of 1,622 deliveries occurred during the 28 weeks of antenatal care. Group A consisted of 805 centralized monitored patients and Group B had 817 noncentralized monitored patients. There was no statistical difference in the 5‐minute Apgar, umbilical artery pH, perinatal mortality, or the NICU admissions between the two groups. However, there was a significant statistical difference in the percent of cesarean sections performed for nonreassuring fetal heart rate tracings (Group A, 17.89% vs. Group B, 12.16%; P = 0.02). The overall cesarean section rate was increased in the centrally monitored group (Group A, 23.6% vs. Group B, 18.1%; P = 0.01). There were also statistically significant differences in operative vaginal deliveries (forceps and vacuum) for fetal heart rate abnormalities between Group A, 0.52% vs. Group B, .39% (P = 0.05). Centralized monitoring may be associated with an increase in the overall cesarean section rate. In addition, the rate of operative vaginal and abdominal deliveries appears to be increased for the indication of nonreassuring fetal heart rate tracings with the use of centralized monitoring. J. Matern.‐Fetal Med. 6:317–319, 1997. © 1997 Wiley‐Liss, Inc.
ISSN:1057-0802
1520-6661
DOI:10.1002/(SICI)1520-6661(199711/12)6:6<317::AID-MFM3>3.0.CO;2-R