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Systematic review of Doppler for detecting intrapartum fetal heart abnormalities and measuring perinatal mortality in low‐ and middle‐income countries
Author(s) -
Plotkin Marya,
Kamala Benjamin,
Ricca Jim,
Fogarty Linda,
Currie Sheena,
Kidanto Hussein,
Wheeler Stephanie B.
Publication year - 2020
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.13014
Subject(s) - medicine , stethoscope , obstetrics , emergency medicine , intensive care medicine , radiology
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 LMIC s. Doppler should be used to calculate a facility indicator of intrapartum care quality. PROSPERO registration: CRD42019121924.