[Evaluation of scalp sampling practice and methods before and after training in intrapartum monitoring].

Abstract

Objective: To compare the methods of performing scalp sampling before and after training teams in per partum monitoring.

Materials and methods: This was a single center (Lille, France), retrospective, before and after study comparing the period 2017-2018 before training and the period 2019-2020 after training. It consisted of 1/ theoretical training with courses on fetal physiology, recognition of risk factors for fetal hypoxia and pathophysiology of fetal acidosis; 2/ practical training with analysis of local clinical cases; 3/ real-life scenarios within the simulation platform. At the same time, a service protocol for scalp stimulation was established. One hundred patients were randomly selected for each period from those who met the inclusion criteria: at least one scalp sampling, cephalic presentation of the fetus, and singleton.

Results: In the 2016-2017 period, 8.7% of patients had a scalp sample and 1.5% in the 2020-2021 period (p<0.001). The percentage of patients who had more than one scalp sample (among those who had at least one) was significantly higher in the pre-training group than in the post-training group (36% vs 11%, p<0.001). There was no significant difference between the two groups in terms of cervical dilation for pH, time to decision/insertion/result/birth, number of operators and attempts, failure rate and finally in terms of the measured parameters.

Conclusion: Training of professionals in intrapartum monitoring, combined with a protocol for scalp stimulation, resulted in less recourse to second-line investigations, but did not change the how scalp sampling were performed.