Intrapartum assessment of fetal acidosis by with vtbroacoustic stimulation

a meta-analysis

Carlos Benito, A. M. Vintiiileos, C. V. Ananth

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To determine the efficacy of vibroacoustic stimulation (VAS) in the prediction of fetal acidosis in laboring patients. STUDY DESIGN: We reviewed studies on VAS in laboring patients published between 1987 and 1995 based on a comprehensive literature search using MEDLINE and by identifying studies cited in the references of published reports. Data on the intrapartum acid base status of the fetus was obtained by fetal scalp blood sampling after vibroacoustic stimulation was performed. Method of VAS stimulation, technique of stimulation and indication for testing were analyzed. A positive response to VAS was defined as an acceleration (accel) of 15 bpm for 15 seconds. Acidosis was defined as a fetal scalp pH of < 7.20. Two by two tables were constructed for each study and sensitivity, specificity, negative and positive predictive values were calculated. Statistical methods applied for the meta-analysis included the fixed effects logistic regression model, while potential sources of heterogeneity among studies were evaluated by fitting random-effects models. Results are reported as odds ratios with 95% confidence intervals (CI). RESULTS: We identified a total of 5 retrospective cohort studies of which four studies met the inclusion criteria for the meta-analysis (fetal scalp pH<7.20) which included a total of 425 patients. Methods and time of stimulation were similar in all studies as were the indications for testing. The incidence of acidosis in laboring patients was 14425(3.2%). The pooled odds ratio for the estimation of acidotic fetuses in patients who did not have accelerations of 15 bprn for 15 seconds after vibroacoustic stimulation was 5.0 (95% CI 1.4-17.5). A test for homogeneity of the random effects pooled odds ratio was preserved (p=0.255). One study based on 64 patients which used a fetal scalp pH threshold of < 7.25 to define acidosis reported an odds ratio of 67.5 (95% CI 3.8-1196.3). CONCLUSION: The results of this meta-analysis indicate that vibroacoustic stimulation can be used in the intrapartum period as a noninvasive technique for the assessment of fetal well being. This may be helpful in reducing the risk for cesarean deliver)' in patients with nonreassuring fetal heart rate tracings in situations where fetai scalp blood sampling may not be possible due intact membranes or an undilated cervix.

Original languageEnglish (US)
JournalActa Diabetologica Latina
Volume176
Issue number1 PART II
StatePublished - Dec 1 1997
Externally publishedYes

Fingerprint

Acidosis
Meta-Analysis
Scalp
Odds Ratio
Confidence Intervals
Fetus
Logistic Models
Fetal Heart Rate
Fetal Blood
Cervix Uteri
MEDLINE
Cohort Studies
Retrospective Studies
Sensitivity and Specificity
Acids
Membranes
Incidence

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

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title = "Intrapartum assessment of fetal acidosis by with vtbroacoustic stimulation: a meta-analysis",
abstract = "OBJECTIVE: To determine the efficacy of vibroacoustic stimulation (VAS) in the prediction of fetal acidosis in laboring patients. STUDY DESIGN: We reviewed studies on VAS in laboring patients published between 1987 and 1995 based on a comprehensive literature search using MEDLINE and by identifying studies cited in the references of published reports. Data on the intrapartum acid base status of the fetus was obtained by fetal scalp blood sampling after vibroacoustic stimulation was performed. Method of VAS stimulation, technique of stimulation and indication for testing were analyzed. A positive response to VAS was defined as an acceleration (accel) of 15 bpm for 15 seconds. Acidosis was defined as a fetal scalp pH of < 7.20. Two by two tables were constructed for each study and sensitivity, specificity, negative and positive predictive values were calculated. Statistical methods applied for the meta-analysis included the fixed effects logistic regression model, while potential sources of heterogeneity among studies were evaluated by fitting random-effects models. Results are reported as odds ratios with 95{\%} confidence intervals (CI). RESULTS: We identified a total of 5 retrospective cohort studies of which four studies met the inclusion criteria for the meta-analysis (fetal scalp pH<7.20) which included a total of 425 patients. Methods and time of stimulation were similar in all studies as were the indications for testing. The incidence of acidosis in laboring patients was 14425(3.2{\%}). The pooled odds ratio for the estimation of acidotic fetuses in patients who did not have accelerations of 15 bprn for 15 seconds after vibroacoustic stimulation was 5.0 (95{\%} CI 1.4-17.5). A test for homogeneity of the random effects pooled odds ratio was preserved (p=0.255). One study based on 64 patients which used a fetal scalp pH threshold of < 7.25 to define acidosis reported an odds ratio of 67.5 (95{\%} CI 3.8-1196.3). CONCLUSION: The results of this meta-analysis indicate that vibroacoustic stimulation can be used in the intrapartum period as a noninvasive technique for the assessment of fetal well being. This may be helpful in reducing the risk for cesarean deliver)' in patients with nonreassuring fetal heart rate tracings in situations where fetai scalp blood sampling may not be possible due intact membranes or an undilated cervix.",
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Intrapartum assessment of fetal acidosis by with vtbroacoustic stimulation : a meta-analysis. / Benito, Carlos; Vintiiileos, A. M.; Ananth, C. V.

In: Acta Diabetologica Latina, Vol. 176, No. 1 PART II, 01.12.1997.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Intrapartum assessment of fetal acidosis by with vtbroacoustic stimulation

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AU - Benito, Carlos

AU - Vintiiileos, A. M.

AU - Ananth, C. V.

PY - 1997/12/1

Y1 - 1997/12/1

N2 - OBJECTIVE: To determine the efficacy of vibroacoustic stimulation (VAS) in the prediction of fetal acidosis in laboring patients. STUDY DESIGN: We reviewed studies on VAS in laboring patients published between 1987 and 1995 based on a comprehensive literature search using MEDLINE and by identifying studies cited in the references of published reports. Data on the intrapartum acid base status of the fetus was obtained by fetal scalp blood sampling after vibroacoustic stimulation was performed. Method of VAS stimulation, technique of stimulation and indication for testing were analyzed. A positive response to VAS was defined as an acceleration (accel) of 15 bpm for 15 seconds. Acidosis was defined as a fetal scalp pH of < 7.20. Two by two tables were constructed for each study and sensitivity, specificity, negative and positive predictive values were calculated. Statistical methods applied for the meta-analysis included the fixed effects logistic regression model, while potential sources of heterogeneity among studies were evaluated by fitting random-effects models. Results are reported as odds ratios with 95% confidence intervals (CI). RESULTS: We identified a total of 5 retrospective cohort studies of which four studies met the inclusion criteria for the meta-analysis (fetal scalp pH<7.20) which included a total of 425 patients. Methods and time of stimulation were similar in all studies as were the indications for testing. The incidence of acidosis in laboring patients was 14425(3.2%). The pooled odds ratio for the estimation of acidotic fetuses in patients who did not have accelerations of 15 bprn for 15 seconds after vibroacoustic stimulation was 5.0 (95% CI 1.4-17.5). A test for homogeneity of the random effects pooled odds ratio was preserved (p=0.255). One study based on 64 patients which used a fetal scalp pH threshold of < 7.25 to define acidosis reported an odds ratio of 67.5 (95% CI 3.8-1196.3). CONCLUSION: The results of this meta-analysis indicate that vibroacoustic stimulation can be used in the intrapartum period as a noninvasive technique for the assessment of fetal well being. This may be helpful in reducing the risk for cesarean deliver)' in patients with nonreassuring fetal heart rate tracings in situations where fetai scalp blood sampling may not be possible due intact membranes or an undilated cervix.

AB - OBJECTIVE: To determine the efficacy of vibroacoustic stimulation (VAS) in the prediction of fetal acidosis in laboring patients. STUDY DESIGN: We reviewed studies on VAS in laboring patients published between 1987 and 1995 based on a comprehensive literature search using MEDLINE and by identifying studies cited in the references of published reports. Data on the intrapartum acid base status of the fetus was obtained by fetal scalp blood sampling after vibroacoustic stimulation was performed. Method of VAS stimulation, technique of stimulation and indication for testing were analyzed. A positive response to VAS was defined as an acceleration (accel) of 15 bpm for 15 seconds. Acidosis was defined as a fetal scalp pH of < 7.20. Two by two tables were constructed for each study and sensitivity, specificity, negative and positive predictive values were calculated. Statistical methods applied for the meta-analysis included the fixed effects logistic regression model, while potential sources of heterogeneity among studies were evaluated by fitting random-effects models. Results are reported as odds ratios with 95% confidence intervals (CI). RESULTS: We identified a total of 5 retrospective cohort studies of which four studies met the inclusion criteria for the meta-analysis (fetal scalp pH<7.20) which included a total of 425 patients. Methods and time of stimulation were similar in all studies as were the indications for testing. The incidence of acidosis in laboring patients was 14425(3.2%). The pooled odds ratio for the estimation of acidotic fetuses in patients who did not have accelerations of 15 bprn for 15 seconds after vibroacoustic stimulation was 5.0 (95% CI 1.4-17.5). A test for homogeneity of the random effects pooled odds ratio was preserved (p=0.255). One study based on 64 patients which used a fetal scalp pH threshold of < 7.25 to define acidosis reported an odds ratio of 67.5 (95% CI 3.8-1196.3). CONCLUSION: The results of this meta-analysis indicate that vibroacoustic stimulation can be used in the intrapartum period as a noninvasive technique for the assessment of fetal well being. This may be helpful in reducing the risk for cesarean deliver)' in patients with nonreassuring fetal heart rate tracings in situations where fetai scalp blood sampling may not be possible due intact membranes or an undilated cervix.

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