Systematic review of Doppler for detecting intrapartum fetal heart abnormalities and measuring perinatal mortality in low- and middle- income countries
Plotkin, Marya; Kamala, Benjamin; Ricca, Jim; Fogarty, Linda; Currie, Sheena; Kidanto, Hussein; Wheeler, Stephanie B.
Peer reviewed, Journal article
Published version
Permanent lenke
https://hdl.handle.net/11250/3047736Utgivelsesdato
2019Metadata
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Originalversjon
Plotkin, M., Kamala, B., Ricca, J., Fogarty, L., Currie, S., Kidanto, H., & Wheeler, S. B. (2020). Systematic review of Doppler for detecting intrapartum fetal heart abnormalities and measuring perinatal mortality in low‐and middle‐income countries. International Journal of Gynecology & Obstetrics, 148(2), 145-156. 10.1002/ijgo.13014Sammendrag
Background
Using Doppler to improve detection of intrapartum fetal heart rate (FHR) abnormalities coupled with appropriate, timely intrapartum care in low- and middle-income countries (LMIC) can save lives.
Objective
To review studies using Doppler to improve detection of intrapartum FHR abnormalities and intrapartum care quality in LMIC health facilities.
Search strategy
PubMed, Web of Science, Embase, Global Health, and Scopus were searched from inception to October 2018 by combining terms for Doppler, perinatal outcomes, and FHR monitoring.
Selection criteria
Selected studies compared Doppler and Pinard stethoscope for detecting/monitoring intrapartum FHR, or described provider and maternal preferences for FHR monitoring in LMIC settings.
Data collection and analysis
Two team members independently screened and collected data. Risk of bias was assessed by Cochrane EPOC criteria.
Results
Eleven studies from eight countries were included. Doppler was superior at detecting abnormal intrapartum FHR as compared with Pinard stethoscope, but was not associated with improved perinatal outcomes. Using Doppler on admission helped to accurately measure perinatal deaths occurring after facility admission.
Conclusion
Studies and program learning are needed to translate improved detection of FHR abnormalities to improved case management in LMICs. Doppler should be used to calculate a facility indicator of intrapartum care quality.