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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
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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
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Journal Article
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
2025
Overview
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 measuresCount 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.
Publisher
British Medical Journal Publishing Group,BMJ Publishing Group LTD,BMJ Publishing Group
Subject
