Granskning av framtagande och kvalitet av riktlinjer för fosterljudsövervakning vid lågriskförlossning i Sverige enligt AGREE II: En totalundersökning

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Sammanfattning: Background: There are 44 obstetric clinic's in Sweden. It is up to each individual to designits own guidelines for different health conditions. It is important to minimize unnecessaryinterventions during labour, partly to reduce risks for the mother and the unborn child, birthexperience and outcomes. The aim of the guidelines of fetal heart rate monitoring (FHM)during low-risk labour is to facilitate and ensure appropriate management. To enable qualityreview of guidelines in health care, the Appraisal of Guidelines Research & Evaluation II(AGREE II) instrument can be applied.Aim: To review the quality of Swedish obstetric clinic's guidelines for FHM in low-risklabour according to AGREE II and to compare possible differences.Method: A quality review according to AGREE II and comparison between guidelinesaccording to an own designed review document is applied.Results: The review according to AGREE II shows that 4/34 guidelines had appropriatequality to be recommended for use in the clinic; 10/34 recommended an updating of theguideline every one or two years; 11/34 guidelines described the purpose of FHM; 20/34recommended continuous CTG monitoring at the second stage of labour; 10/34 used scientificarticles in the developmental process; 4/34 had at least one midwife involved in thedevelopment of the guideline 1/34 recommended patient consent for FHM.Conclusion: The examined guidelines lack in quality based on AGREE II. To get knowledgewhether unnecessary interventions are performed, a comparison between each clinic'sdelivery outcomes needs to be performed.Key words: Appraisal of Guidelines Research & Evaluation II (AGREE II),cardiotocography, clinical guidelines, evidence-based care, equal care, low-risk labour,midwives

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