Yambasu Sahr D, Percival Crystal Rose, Hayes Lauren, Shahabuddin Yulia, Murphy Deirdre J
Academic Department of Obstetrics and Gynecology, The Coombe Hospital & Trinity College, University of Dublin, Dublin 2, Republic of Ireland.
Academic Department of Obstetrics and Gynecology, The Coombe Hospital & Trinity College, University of Dublin, Dublin 2, Republic of Ireland.
Eur J Obstet Gynecol Reprod Biol. 2025 Jun;310:113973. doi: 10.1016/j.ejogrb.2025.113973. Epub 2025 Apr 11.
The aim of this study was to evaluate obstetricians' views on digital fetal scalp stimulation (dFSS) and fetal blood sampling (FBS), and to establish their reported practice when performing second line tests of fetal wellbeing in labor.
A survey was distributed via email and post to every trainee and consultant obstetrician in maternity units in the Republic of Ireland. The survey explored current practice, views on test performance, and the management of clinical scenarios with abnormal intrapartum cardiotocography.
We received 177 responses from 430 doctors (41 %). There was a perception that dFSS is easier (93 %) and faster to perform (94 %), but that FBS is the most reliable test (59 % FBS, 5 % dFSS, 22 % no difference). The need for a well-designed randomized controlled trial to determine which test performs best was recognized (80 %). Willingness to participate in such a trial was higher among trainees than consultants (91 % versus 67 %, p = 0.001). There was marked variation in reported practice for the clinical scenarios and diverse views were expressed within the free-text comments.
Perspectives on dFSS and FBS vary between clinicians. This uncertainty about commonly used intrapartum tests supports the need for randomized controlled trials to provide robust evidence on the effectiveness of each test.
本研究旨在评估产科医生对数字胎儿头皮刺激（dFSS）和胎儿血样采集（FBS）的看法，并确定他们在产时进行胎儿健康二线检测时的报告实践。
通过电子邮件和邮寄方式向爱尔兰共和国产科单位的每位实习医生和顾问产科医生发放调查问卷。该调查探讨了当前的实践、对检测性能的看法以及产时胎心监护异常的临床情况管理。
我们收到了来自430名医生的177份回复（41%）。人们认为dFSS更容易操作（93%）且执行速度更快（94%），但FBS是最可靠的检测方法（59%认为FBS最可靠，5%认为dFSS最可靠，22%认为无差异）。80%的人认识到需要进行精心设计的随机对照试验来确定哪种检测方法效果最佳。实习生比顾问更愿意参与这样的试验（91%对67%，p = 0.001）。在临床情况的报告实践中存在显著差异，在自由文本评论中也表达了不同的观点。
临床医生对dFSS和FBS的看法各不相同。对于常用的产时检测方法存在这种不确定性，这支持了进行随机对照试验以提供每种检测方法有效性的确凿证据的必要性。
