Intrapartum fetal surveillance: Summary of four national evidence-based guidelines and need to develop indian guidelines

Introduction: There are more deliveries in India than any country in the world, according to World Health Report. Review of seven articles published in The Journal of Obstetrics and Gynecology of India suggests that the perinatal mortality (PNM) in the country is 92/1,000 (16,339/177,998) births and the cause is asphyxia in about one fourth of the cases. Methods:We reviewed the evidencebased guidelines on intrapartum fetal surveillance from four countries (UK, USA, Canada, and Australia/New Zealand). Results: Overall there were 72 recommendations and whether they were level A, B, C, or D varied significantly (p=0.021) for the four national guidelines. The composite summary of these recommendations indicates that no single guideline is comprehensive, the composite may be better than any singular. Conclusion: Each country needs its own recommendations to ameliorate the PNM. Accounting for the varied setting childbirths occurring in the country, a national guideline for clinicians in India may decrease the PNM secondary to asphyxia.