ArticleEuropean journal of obstetrics & gynecology and reproductive biology: X2021
Low sensitivity of the new FIGO classification system for electronic fetal monitoring to identify fetal acidosis in the second stage of labor.
Article in European journal of obstetrics & gynecology and reproductive biology: X, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 23 citations in OpenAlex.
- Large-scale analysis of interobserver agreement and reliability in cardiotocography interpretation during labor using an online tool.BMC pregnancy and childbirth · 2024Trial
- An attempt to improve recognition of fetal acidemia by a remodeled intrapartum cardiotocography classification: A case-control study.Acta obstetricia et gynecologica Scandinavica · 2026Article
- Fetal heart rate patterns associated with acidemia at fetal blood sampling during labor-An observational study.Acta obstetricia et gynecologica Scandinavica · 2026Article
- Physiological cardiotocography interpretation and neonatal morbidity: A historical pre-post cohort study in a tertiary perinatal center.Acta obstetricia et gynecologica Scandinavica · 2026Article
- Contraction frequency and acidemia at birth: A case-control study.Acta obstetricia et gynecologica Scandinavica · 2026Article
- Twenty-year trends in fetal scalp-blood sampling and birth outcomes: A single-center retrospective cohort study of 40 309 women in labor.Acta obstetricia et gynecologica Scandinavica · 2026Article
- Predicting Intrapartum Acidemia: A Review of Approaches Based on Fetal Heart Rate.Bioengineering (Basel, Switzerland) · 2026Review
- Detection of Nuchal Cord Based on Specific CTG Patterns Intrapartum - A Myth?Geburtshilfe und Frauenheilkunde · 2025Article
- Association between different types and characteristics of fetal deceleration during labour and neonatal acidemia at delivery: A case-control study.European journal of obstetrics & gynecology and reproductive biology: X · 2025Article
- Frequency of fetal blood sampling, delivery mode and neonatal outcome after revised CTG-classification and updated lactate meter in Sweden: An observational study.Acta obstetricia et gynecologica Scandinavica · 2025Observational
- Diagnostic Ability and Reproducibility of NICE 2017 Intrapartum Cardiotocography Interpretation Guidelines: A Prospective Observational Study.Journal of obstetrics and gynaecology of India · 2025Article
- Is the fetus fit for labor? Introducing fast-and-frugal trees (FFTrees) to simplify triage of women for STAN monitoring: An interobserver agreement comparison with traditional classification.Acta obstetricia et gynecologica Scandinavica · 2024Article
- The cumulative incidence of neonatal metabolic acidemia after terminal bradycardia in the 2nd stage of labor: a survival-based model.Archives of gynecology and obstetrics · 2023Article
- Comparison of fetal heart rate baseline estimation by the cardiotocograph network and clinicians: a multidatabase retrospective assessment study.Frontiers in cardiovascular medicine · 2023Article
- Implementation of a revised classification for intrapartum fetal heart rate monitoring and association to birth outcome: A national cohort study.Acta obstetricia et gynecologica Scandinavica · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveIn 2015, new FIGO guidelines for CTG interpretation were presented (FIGO-15). In 2017, the previous Swedish guidelines (SWE-09) were replaced with guidelines adapted to FIGOs (SWE-17). The performance of these three templates had not been scientifically evaluated before its clinical implementation. The objective of this study was to compare the sensitivity and specificity to detect fetal acidosis at birth using these three templates during the second stage of labor. STUDY
designThis case-control study included 295 neonates with cord blood pH < 7.05 and 591 controls with pH ≥ 7.15, born 2012-2017. Tracings from the last 30-80 min of labor were classified independently by three assessors (midwives, residents and obstetricians), blinded to group and outcome.
resultsThe classification pathological using FIGO-15 had a sensitivity of 50 % and specificity of 88 % in detecting fetuses with acidosis. For SWE-17, the sensitivity was 62 % and the specificity 85 %. For SWE-09 the sensitivity was 87 % and the specificity 56 %.By combining suspicious and pathological patterns the sensitivity for FIGO-15 increased to 97 %, and for SWE-17 to 83 %, whereas the specificity decreased to 23 % and 68 % respectively.
conclusionsThe FIGO classification seemed to be insufficiently discriminative in the second stage of labor; most patterns in acidotic cases were classified as merely suspicious with this template, and the sensitivity of pathological patterns was low at 50 %. Combined pathological and suspicious patterns detected fetal acidosis at a specificity that was too low to be useful (23 %). SWE-09 showed the best ability to detect acidosis with pathological patterns (sensitivity 87 %). SWE-17 reached almost the same sensitivity (83 %) with the combination of suspicious and pathological patterns, and at a higher specificity (68 %).
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.