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Article Dans Une Revue Journal of Gynecology Obstetrics and Human Reproduction Année : 2021

Evaluation and impact of fetal physiology training on fetal heart rate analysis

Résumé

Introduction Evaluation of fetal well-being during labor is based on fetal heart rate (FHR) analysis, which requires physiology expertise. The aim of the present study was to assess medical residents’ fetal physiology training in terms of theoretical knowledge, FHR interpretation, and use of second-line examinations. Methods This single-center, prospective study of obstetrics and gynecology residents (N = 34) at CHU de Lille Hospital (Lille, France) was conducted from November 2017 to November 2018. Evaluation and training were conducted in three stages. First, residents’ pre-training knowledge of FHR interpretation and use of fetal scalp blood sampling (FBS) was assessed using clinical cases. Second, a didactic training session on fetal physiology was delivered. Finally, post-training knowledge was evaluated using the same cases presented during pre-training. i Pre-training, 3%, 11.8%, and 14.7% of residents considered their training on fetal physiology, FHR analysis, and second-line examinations, respectively, to be sufficient. Training significantly improved their theoretical knowledge, which was assessed using multiple-choice questions (median [interquartile range]: 1.5 [1.0–2.0] vs. 4.0 [3.0–4.5], p<0.001), and reduced the number of FBS requested (36.3% vs. 29.5%, p = 0.002). Krippendorff's alpha coefficient for the reproducibility of residents’ responses improved significantly, reflecting greater homogenization of clinical practice decisions (alpha [95% confidence interval]: 0.60 [0.55–0.65] vs. 0.72 [0.67–0.76]). Conclusion Improved fetal physiology knowledge promotes more accurate FHR interpretation, better indications for second-line examinations, and greater homogenization of clinical practice decisions. Future studies should evaluate the impact of fetal physiology training on clinical practice.

Dates et versions

hal-04521412 , version 1 (26-03-2024)

Identifiants

Citer

Hippolyte Dupuis, Louise Ghesquière, Adeline Pierache, Damien Subtil, Veronique Debarge, et al.. Evaluation and impact of fetal physiology training on fetal heart rate analysis. Journal of Gynecology Obstetrics and Human Reproduction, 2021, Journal of Gynecology Obstetrics and Human Reproduction, 50 (10), pp.102185. ⟨10.1016/j.jogoh.2021.102185⟩. ⟨hal-04521412⟩

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