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Kuah S, Simpson B, Salter A, Matthews G, Louise J, Bednarz J, Chandraharan E, Symonds I, McPhee A, Mol BW, Turnbull D, Wilkinson C. Comparison of effect of CTG + STan with CTG alone on emergency Cesarean section rate: STan Australian Randomized controlled Trial (START). Ultrasound Obstet Gynecol 2023; 62:462-470. [PMID: 37289946 PMCID: PMC10946943 DOI: 10.1002/uog.26279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 05/11/2023] [Accepted: 05/24/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To investigate whether use of ST analysis of the fetal electrocardiogram (STan) as an adjunct to continuous cardiotocography (CTG) reduces the rate of emergency Cesarean section (EmCS) compared with CTG alone. METHODS This was a randomized controlled trial of patients with a singleton fetus in cephalic presentation at ≥ 36 weeks' gestation, requiring continuous electronic fetal monitoring during labor at a tertiary maternity hospital in Adelaide, Australia, between January 2018 and July 2021. Participants were randomized to undergo CTG + STan or CTG alone. The calculated sample size was 1818 participants. The primary outcome was EmCS. Secondary outcomes included metabolic acidosis, a composite adverse perinatal outcome, and other maternal and neonatal morbidity and safety outcomes. RESULTS The present study enrolled 970 women, of whom 967 were included in the primary analysis. EmCS occurred in 107/482 (22.2%) deliveries in the CTG + STan arm and in 107/485 (22.1%) in the CTG arm (adjusted relative risk, 1.02 (95% CI, 0.81-1.27); P = 0.89). There was no difference in the rate of adverse maternal or neonatal outcomes between arms. CONCLUSIONS The addition of STan as an adjunct to continuous CTG did not reduce the EmCS rate. The smaller-than-anticipated sample size meant that this study was underpowered to detect absolute differences of ≤ 5% and, therefore, this negative finding could be due to a Type-2 error. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- S. Kuah
- Women's and Children's HospitalNorth AdelaideSAAustralia
| | - B. Simpson
- Women's and Children's HospitalNorth AdelaideSAAustralia
- Women's and Children's Health, Adelaide Medical SchoolUniversity of AdelaideNorth AdelaideSAAustralia
| | - A. Salter
- School of Public Health, Faculty of Health and Medical SciencesUniversity of AdelaideAdelaideSAAustralia
| | - G. Matthews
- Women's and Children's HospitalNorth AdelaideSAAustralia
| | - J. Louise
- Women's and Children's Hospital, Faculty of Health and Medical SciencesUniversity of AdelaideNorth AdelaideSAAustralia
| | - J. Bednarz
- School of Public Health, Faculty of Health and Medical SciencesUniversity of AdelaideAdelaideSAAustralia
- South Australian Health and Medical Research InstituteSAHMRI Women and KidsNorth AdelaideSAAustralia
| | - E. Chandraharan
- Global Academy of Medical Education and Training LtdLondonUK
| | - I. Symonds
- Adelaide Medical School, Faculty of Health and Medical SciencesUniversity of AdelaideAdelaideSAAustralia
| | - A. McPhee
- South Australian Health and Medical Research InstituteSAHMRI Women and KidsNorth AdelaideSAAustralia
| | - B. W. Mol
- Department of Obstetrics and GynaecologyMonash UniversityClaytonVICAustralia
- Aberdeen Centre for Women's Health Research, School of Medicine, Medical Sciences and NutritionUniversity of AberdeenAberdeenUK
| | - D. Turnbull
- School of Psychology, Faculty of Health and Medical SciencesUniversity of AdelaideAdelaideSAAustralia
| | - C. Wilkinson
- Women's and Children's HospitalNorth AdelaideSAAustralia
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Udagawa C, Kuah S, Shimoi T, Kato K, Yoshida T, Nakano MH, Shimo A, Kojima Y, Yoshie R, Tsugawa K, Mushiroda T, Tan EY, Zembutsu H. Replication Study for the Association of Five SNPs Identified by GWAS and Trastuzumab-Induced Cardiotoxicity in Japanese and Singaporean Cohorts. Biol Pharm Bull 2022; 45:1198-1202. [DOI: 10.1248/bpb.b22-00136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Chihiro Udagawa
- Department of Genetics Medicine and services, National Cancer Center Hospital
| | - Sherwin Kuah
- Department of General Surgery, Tan Tock Seng Hospital
| | | | - Ken Kato
- Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital
| | - Teruhiko Yoshida
- Department of Genetics Medicine and services, National Cancer Center Hospital
| | - Mari Hara Nakano
- Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine
| | - Arata Shimo
- Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine
| | - Yasuyuki Kojima
- Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine
| | - Reiko Yoshie
- Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine
| | - Koichiro Tsugawa
- Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine
| | - Taisei Mushiroda
- Laboratory for Pharmacogenomics, RIKEN Center for Integrative Medical Science
| | - Ern Yu Tan
- Department of General Surgery, Tan Tock Seng Hospital
| | - Hitoshi Zembutsu
- Department of Clinical Genomics, National Cancer Center Research Institute
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Ong SS, Ho PJ, Khng AJ, Lim EH, Wong FY, Tan BKT, Lim SH, Tan EY, Tan SM, Tan VKM, Dent R, Tan TJY, Ngeow J, Madhukumar P, Hamzah JLB, Sim Y, Lim GH, Pang JS, Alcantara VS, Chan PMY, Chen JJC, Kuah S, Seah JCM, Buhari SA, Tang SW, Ng CWQ, Li J, Hartman M. Association between Breast Cancer Polygenic Risk Score and Chemotherapy-Induced Febrile Neutropenia: Null Results. Cancers (Basel) 2022; 14:cancers14112714. [PMID: 35681694 PMCID: PMC9179461 DOI: 10.3390/cancers14112714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/17/2022] [Accepted: 05/26/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The hypothesis that breast cancer (BC) susceptibility variants are linked to chemotherapy-induced toxicity has been previously explored. Here, we investigated the association between a validated 313-marker-based BC polygenic risk score (PRS) and chemotherapy-induced neutropenia without fever and febrile neutropenia (FNc) in Asian BC patients. METHODS This observational case-control study of Asian BC patients treated with chemotherapy included 161 FNc patients, 219 neutropenia patients, and 936 patients who did not develop neutropenia. A continuous PRS was calculated by summing weighted risk alleles associated with overall, estrogen receptor- (ER-) positive, and ER-negative BC risk. PRS distributions neutropenia or FNc cases were compared to controls who did not develop neutropenia using two-sample t-tests. Odds ratios (OR) and corresponding 95% confidence intervals were estimated for the associations between PRS (quartiles and per standard deviation (SD) increase) and neutropenia-related outcomes compared to controls. RESULTS PRS distributions were not significantly different in any of the comparisons. Higher PRSoverall quartiles were negatively correlated with neutropenia or FNc. However, the associations were not statistically significant (PRS per SD increase OR neutropenia: 0.91 [0.79-1.06]; FNc: 0.87 [0.73-1.03]). No dose-dependent trend was observed for the ER-positive weighted PRS (PRSER-pos) and ER-negative weighted PRS (PRSER-neg). CONCLUSION BC PRS was not strongly associated with chemotherapy-induced neutropenia or FNc.
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Affiliation(s)
- Seeu Si Ong
- Women’s Health and Genetics, Genome Institute of Singapore, 60 Biopolis Street, Genome, #02-01, Singapore 138672, Singapore; (S.S.O.); (P.J.H.); (A.J.K.)
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore;
| | - Peh Joo Ho
- Women’s Health and Genetics, Genome Institute of Singapore, 60 Biopolis Street, Genome, #02-01, Singapore 138672, Singapore; (S.S.O.); (P.J.H.); (A.J.K.)
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore;
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore
| | - Alexis Jiaying Khng
- Women’s Health and Genetics, Genome Institute of Singapore, 60 Biopolis Street, Genome, #02-01, Singapore 138672, Singapore; (S.S.O.); (P.J.H.); (A.J.K.)
| | - Elaine Hsuen Lim
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore 169610, Singapore; (E.H.L.); (R.D.); (T.J.Y.T.); (J.N.)
| | - Fuh Yong Wong
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore 169610, Singapore;
| | - Benita Kiat-Tee Tan
- Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore 169610, Singapore; (B.K.-T.T.); (V.K.M.T.); (P.M.); (J.L.B.H.); (Y.S.)
- Department of Breast Surgery, Singapore General Hospital, Singapore 169608, Singapore
- Department of General Surgery, Sengkang General Hospital, Singapore 544886, Singapore
| | - Swee Ho Lim
- KK Breast Department, KK Women’s and Children’s Hospital, Singapore 229899, Singapore; (S.H.L.); (G.H.L.); (J.S.P.); (V.S.A.)
| | - Ern Yu Tan
- Department of General Surgery, Tan Tock Seng Hospital, Singapore 308433, Singapore; (E.Y.T.); (P.M.Y.C.); (J.J.C.C.); (S.K.)
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
- Institute of Molecular and Cell Biology, Singapore 138673, Singapore
| | - Su-Ming Tan
- Division of Breast Surgery, Changi General Hospital, Singapore 529889, Singapore; (S.-M.T.); (J.C.M.S.)
| | - Veronique Kiak Mien Tan
- Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore 169610, Singapore; (B.K.-T.T.); (V.K.M.T.); (P.M.); (J.L.B.H.); (Y.S.)
- Department of Breast Surgery, Singapore General Hospital, Singapore 169608, Singapore
| | - Rebecca Dent
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore 169610, Singapore; (E.H.L.); (R.D.); (T.J.Y.T.); (J.N.)
| | - Tira Jing Ying Tan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore 169610, Singapore; (E.H.L.); (R.D.); (T.J.Y.T.); (J.N.)
| | - Joanne Ngeow
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore 169610, Singapore; (E.H.L.); (R.D.); (T.J.Y.T.); (J.N.)
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
- Institute of Molecular and Cell Biology, Singapore 138673, Singapore
| | - Preetha Madhukumar
- Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore 169610, Singapore; (B.K.-T.T.); (V.K.M.T.); (P.M.); (J.L.B.H.); (Y.S.)
- Department of Breast Surgery, Singapore General Hospital, Singapore 169608, Singapore
| | - Julie Liana Bte Hamzah
- Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore 169610, Singapore; (B.K.-T.T.); (V.K.M.T.); (P.M.); (J.L.B.H.); (Y.S.)
- Department of Breast Surgery, Singapore General Hospital, Singapore 169608, Singapore
| | - Yirong Sim
- Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore 169610, Singapore; (B.K.-T.T.); (V.K.M.T.); (P.M.); (J.L.B.H.); (Y.S.)
- Department of Breast Surgery, Singapore General Hospital, Singapore 169608, Singapore
| | - Geok Hoon Lim
- KK Breast Department, KK Women’s and Children’s Hospital, Singapore 229899, Singapore; (S.H.L.); (G.H.L.); (J.S.P.); (V.S.A.)
| | - Jinnie Siyan Pang
- KK Breast Department, KK Women’s and Children’s Hospital, Singapore 229899, Singapore; (S.H.L.); (G.H.L.); (J.S.P.); (V.S.A.)
| | - Veronica Siton Alcantara
- KK Breast Department, KK Women’s and Children’s Hospital, Singapore 229899, Singapore; (S.H.L.); (G.H.L.); (J.S.P.); (V.S.A.)
| | - Patrick Mun Yew Chan
- Department of General Surgery, Tan Tock Seng Hospital, Singapore 308433, Singapore; (E.Y.T.); (P.M.Y.C.); (J.J.C.C.); (S.K.)
| | - Juliana Jia Chuan Chen
- Department of General Surgery, Tan Tock Seng Hospital, Singapore 308433, Singapore; (E.Y.T.); (P.M.Y.C.); (J.J.C.C.); (S.K.)
| | - Sherwin Kuah
- Department of General Surgery, Tan Tock Seng Hospital, Singapore 308433, Singapore; (E.Y.T.); (P.M.Y.C.); (J.J.C.C.); (S.K.)
| | - Jaime Chin Mui Seah
- Division of Breast Surgery, Changi General Hospital, Singapore 529889, Singapore; (S.-M.T.); (J.C.M.S.)
| | - Shaik Ahmad Buhari
- Department of Surgery, University Surgical Cluster, National University Health System, Singapore 119228, Singapore; (S.A.B.); (S.W.T.); (C.W.Q.N.)
| | - Siau Wei Tang
- Department of Surgery, University Surgical Cluster, National University Health System, Singapore 119228, Singapore; (S.A.B.); (S.W.T.); (C.W.Q.N.)
| | - Celene Wei Qi Ng
- Department of Surgery, University Surgical Cluster, National University Health System, Singapore 119228, Singapore; (S.A.B.); (S.W.T.); (C.W.Q.N.)
| | - Jingmei Li
- Women’s Health and Genetics, Genome Institute of Singapore, 60 Biopolis Street, Genome, #02-01, Singapore 138672, Singapore; (S.S.O.); (P.J.H.); (A.J.K.)
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore;
- Correspondence: ; Tel.: +65-6808-8312
| | - Mikael Hartman
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore;
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore
- Department of Surgery, University Surgical Cluster, National University Health System, Singapore 119228, Singapore; (S.A.B.); (S.W.T.); (C.W.Q.N.)
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Khine WWT, Rahayu ES, See TY, Kuah S, Salminen S, Nakayama J, Lee YK. Indonesian children fecal microbiome from birth until weaning was different from microbiomes of their mothers. Gut Microbes 2020; 12:1761240. [PMID: 32453977 PMCID: PMC7524161 DOI: 10.1080/19490976.2020.1761240] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Gastrointestinal (GI) microbiota play an important role in human health and wellbeing and the first wave of gut microbes arrives mostly through vertical transmission from mother to child. This study has undertaken to understand the microbiota profile of healthy Southeast Asian mother-infant pairs. Here, we examined the fecal, vaginal and breast milk microbiota of Indonesian mothers and the fecal microbiota of their children from less than 1 month to 48 months old. To determine the immune status of children and the effect of diet at different ages, we examined the level of cytokines, bile acids in the fecal water and weaning food frequency. The fecal microbiota of the children before weaning contained mainly Bacteroides and Bifidobacterium, which presented at low abundance in the samples of mothers. After weaning, the fecal microbiome of children was mainly of the Prevotella type, with decreasing levels of Bifidobacterium, thus becoming more like the fecal microbiome of the mother. The abundance of infant fecal commensals generally correlated inversely with potential pathogens before weaning. The fecal Bifidobacterium in children correlated inversely with the consumption of complex carbohydrates and fruits after weaning. The specific cytokines related to the proliferation and maturation of immunity were found to increase after weaning. A decreasing level of primary bile acids and an increase of secondary bile acids were observed after weaning. This study highlights the change in the GI microbiota of infants to adult-type microbiota after weaning and identifies diet as a major contributing factor.
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Affiliation(s)
- Wei Wei Thwe Khine
- Department of Microbiology & Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Functional Foods Forum, Faculty of Medicine, University of Turku, Turku, Finland
| | - Endang Sutriswati Rahayu
- Faculty of Agricultural Technology and Center for Food & Nutrition Studies, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Ting Yi See
- Department of Microbiology & Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Sherwin Kuah
- Department of Microbiology & Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Seppo Salminen
- Functional Foods Forum, Faculty of Medicine, University of Turku, Turku, Finland
| | - Jiro Nakayama
- Department of Bioscience and Biotechnology, Faculty of Agriculture, Kyushu University, Fukuoka, Japan
| | - Yuan-Kun Lee
- Department of Microbiology & Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Department of Surgery, National University Hospital, Singapore,CONTACT Yuan-Kun Lee Department of Microbiology & Immunology, Yong Loo Lin School of Medicine, National University of Singapore, 5 Science Drive 2117545, Singapore
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Turnbull D, Salter A, Simpson B, Mol BW, Chandraharan E, McPhee A, Symonds I, Benton M, Kuah S, Matthews G, Howard K, Wilkinson C. Comparing the effect of STan (cardiotocographic electronic fetal monitoring (CTG) plus analysis of the ST segment of the fetal electrocardiogram) with CTG alone on emergency caesarean section rates: study protocol for the STan Australian Randomised controlled Trial (START). Trials 2019; 20:539. [PMID: 31464638 PMCID: PMC6716809 DOI: 10.1186/s13063-019-3640-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 08/08/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cardiotocography is almost ubiquitous in its use in intrapartum care. Although it has been demonstrated that there is some benefit from continuous intrapartum fetal monitoring using cardiotocography, there is also an increased risk of caesarean section which is accompanied by short-term and long-term risks to the mother and child. There is considerable potential to reduce unnecessary operative delivery with up to a 60% false positive diagnosis of fetal distress using cardiotocography alone. ST analysis of the fetal electrocardiogram is a promising adjunct to cardiotocography alone, and permits detection of metabolic acidosis of the fetus, potentially reducing false positive diagnosis of fetal distress. METHODS This study will be a single-centre, parallel-group, randomised controlled trial, conducted over 3 years. The primary hypothesis will be that the proportion of women with an emergency caesarean section on ST analysis will not equal that for women on cardiotocography monitoring alone. Participants will be recruited at the Women's and Children's Hospital, a high-risk specialty facility with approximately 5000 deliveries per annum. A total of 1818 women will be randomised to the treatment or conventional arm with an allocation ratio of 1:1, stratified by parity. The primary outcome is emergency caesarean section (yes/no). Statistical analysis will follow standard methods for randomised trials and will be performed on an intention-to-treat basis. Secondary maternal and neonatal outcomes will also be analysed. Additional study outcomes include psychosocial outcomes, patient preferences and cost-effectiveness. DISCUSSION Approximately 20% of Australian babies are delivered by emergency caesarean section. This will be the first Australian trial to examine ST analysis of the fetal electrocardiogram as an adjunct to cardiotocography as a potential method for reducing this proportion. The trial will be among the first to comprehensively examine ST analysis, taking into account the impact on psychosocial well-being as well as cost-effectiveness. This research will provide Australian evidence for clinical practice and guideline development as well as for policy-makers and consumers to make informed, evidence-based choices about care in labour. TRIAL REGISTRATION ANZCTR, ACTRN1261800006268 . Registered on 19 January 2018.
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Affiliation(s)
- D Turnbull
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| | - A Salter
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | - B Simpson
- Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - B W Mol
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia
| | - E Chandraharan
- NHS Foundation Trust, St George's University Hospitals, London, UK
| | - A McPhee
- Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - I Symonds
- Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - M Benton
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| | - S Kuah
- Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - G Matthews
- Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - K Howard
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - C Wilkinson
- Women's and Children's Hospital, Adelaide, South Australia, Australia.
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6
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Mayes ME, Wilkinson C, Kuah S, Matthews G, Turnbull D. Change in practice: a qualitative exploration of midwives' and doctors' views about the introduction of STan monitoring in an Australian hospital. BMC Health Serv Res 2018; 18:119. [PMID: 29454359 PMCID: PMC5816378 DOI: 10.1186/s12913-018-2920-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 02/06/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The present study examines the introduction of an innovation in intrapartum foetal monitoring practice in Australia. ST-Analysis (STan) is a technology that adds information to conventional fetal monitoring (cardiotocography) during labour, with the aim of reducing unnecessary obstetric intervention. Adoption of this technology has been controversial amongst obstetricians and midwives, particularly as its use necessitates a more invasive means of monitoring (a scalp clip), compared to external monitoring from cardiotocography alone. If adoption of this technology is going to be successful, then understanding staff opinions about the implementation of STan in an Australian setting is an important issue for maternity care providers and policy makers. METHODS Using a maximum variation purposive sampling method, 18 interviews were conducted with 10 midwives and 8 doctors from the Women's and Children's Hospital, South Australia to explore views about the introduction of the new technology. The data were analysed using Framework Analysis. RESULTS Midwives and doctors indicated four important areas of consideration when introducing STan: 1) philosophy of care; 2) the implementation process including training and education; 3) the existence of research evidence; and 4) attitudes towards the new technology. Views were expressed about the management of change process, the fit of the new technology within the current models of care, the need for ongoing training and the importance of having local evidence. CONCLUSIONS These findings, coupled with the general literature about introducing innovation and change, can be used by other centres looking to introduce STan technology.
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Affiliation(s)
- M E Mayes
- School of Psychology, University of Adelaide, Room 721a, Hughes Building, North Tce, Adelaide, SA, 5005, Australia.
| | - C Wilkinson
- School of Psychology, University of Adelaide, Room 721a, Hughes Building, North Tce, Adelaide, SA, 5005, Australia
| | - S Kuah
- School of Psychology, University of Adelaide, Room 721a, Hughes Building, North Tce, Adelaide, SA, 5005, Australia
| | - G Matthews
- School of Psychology, University of Adelaide, Room 721a, Hughes Building, North Tce, Adelaide, SA, 5005, Australia
| | - D Turnbull
- School of Psychology, University of Adelaide, Room 721a, Hughes Building, North Tce, Adelaide, SA, 5005, Australia
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