Evidence map›Paper›PMID 40050068›Full record

ArticleBMJ open2025

Detecting and responding to deterioration of a baby during labour: surveys of maternity professionals to inform co-design and implementation of a new standardised approach.

Jan W van der Scheer, Margaret Blott, Mary Dixon-Woods, Annabelle Olsson, Jordan Moxey, Sarah Kelly, Matthew Woodward, Giulia Maistrello, Wendy Randall, Sarah Blackwell and 8 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Jan W van der ScheerTHIS Institute (The Healthcare Improvement Studies Institute), University of Cambridge, Cambridge, UK jan.vanderscheer@Thisinstitute.cam.ac.uk.ORCID http://orcid.org/0000-0002-4368-0355
Margaret BlottRoyal College of Obstetricians and Gynaecologists, London, UK.
Mary Dixon-WoodsTHIS Institute (The Healthcare Improvement Studies Institute), University of Cambridge, Cambridge, UK.
Annabelle OlssonTHIS Institute (The Healthcare Improvement Studies Institute), University of Cambridge, Cambridge, UK.
Jordan MoxeyTHIS Institute (The Healthcare Improvement Studies Institute), University of Cambridge, Cambridge, UK.
Sarah KellyTHIS Institute (The Healthcare Improvement Studies Institute), University of Cambridge, Cambridge, UK.ORCID http://orcid.org/0000-0002-1114-2456
Matthew WoodwardTHIS Institute (The Healthcare Improvement Studies Institute), University of Cambridge, Cambridge, UK.ORCID http://orcid.org/0000-0003-4249-1947
Giulia MaistrelloRAND Europe, Cambridge, UK.
Wendy RandallThe Royal College of Midwives, London, UK.
Sarah BlackwellThe Royal College of Midwives, London, UK.
Chloe HughesThe Royal College of Midwives, London, UK.
Caroline WalkerThe Royal College of Midwives, London, UK.
Louise DewickRoyal College of Obstetricians and Gynaecologists, London, UK.
Rachna BahlRoyal College of Obstetricians and Gynaecologists, London, UK.
Tim J DraycottRoyal College of Obstetricians and Gynaecologists, London, UK.
Thiscovery Authorship Group
ABC Contributor Group
Jenni BurtTHIS Institute (The Healthcare Improvement Studies Institute), University of Cambridge, Cambridge, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesDetecting and responding to deterioration of a baby during labour is likely to benefit from a standardised approach supported by principles of track-and-trigger systems. To inform co-design of a standardised approach and associated implementation strategies, we sought the views of UK-based maternity professionals.

designTwo successive cross-sectional surveys were hosted on an online collaboration platform (Thiscovery) between July 2021 and April 2022.

settingUK.

participantsAcross both surveys, 765 UK-based maternity professionals. PRIMARY AND SECONDARY OUTCOME MEASURES: Count and percentage of participants selecting closed-ended response options, and categorisation and counting of free-text responses.

resultsMore than 90% of participants supported the principle of a standardised approach that systematically considers a range of intrapartum risk factors alongside fetal heart rate features. Over 80% of participants agreed on the importance of a proposed set of evidence-based risk factors underpinning such an approach, but many (over 75%) also indicated a need to clarify the clinical definitions of the proposed risk factors. A need for clarity was also suggested by participants' widely varying views on thresholds for actions of the proposed risk factors, particularly for meconium-stained liquor, rise in baseline fetal heart rate and changes in fetal heart rate variability. Most participants (>75%) considered a range of resources to support good practice as very useful when implementing the approach, such as when and how to escalate in different situations (82%), how to create a supportive culture (79%) and effective communication and decision-making with those in labour and their partners (75%).

conclusionsWe found strong professional support for the principle of a standardised approach to detection and response to intrapartum fetal deterioration and high agreement on the clinical importance of a set of evidence-based risk factors. Further work is needed to address: (1) clarity of clinical definitions of some risk factors, (2) building evidence and agreement on thresholds for action and (3) deimplementation strategies for existing local practices.

Indexed as

Labor, ObstetricAdultAttitude of Health PersonnelCross-Sectional StudiesFemaleHeart Rate, FetalHumansInfant, NewbornPregnancyRisk FactorsSurveys and QuestionnairesUnited KingdomCapacity BuildingHealth & safetyNEONATOLOGYOBSTETRICSQuality ImprovementSurveys and Questionnaires

Identifiers

PMID40050068
PMCPMC11887309

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.