Risk Management: Strip Reviews—Strategies and Best Practices
November 2009
There is a wide variation in the way obstetricians interpret and respond to EFM tracings.
In a recent study, four obstetricians examined 50 tracings.
They agreed in only 22 percent of the cases.
Two months later, they reviewed the same 50 tracings and interpreted 21 percent of the tracings differently than they did the first time.
In another study, five obstetricians independently interpreted 150 tracings.
They similarly only agreed on only 29 percent of the tracings.
What would you do?
What should be done?
2 hrs later, she is at 6 cm, 90% effaced, 1+ station
What should be done?
4 hrs later, she is at 8 cm, 100% effaced, +2 station
What should be done?
34 year-old G2P1 at 38 wks EGA in active labor, cervix 4 cm, 80%, 0 station
This presentation describes the importance of a structured approach for strip review, discusses the NICHD criteria and its limitations and recommends potential management options for the entire L&D team.
