Professor Declan Devane is Professor of Midwifery at the National University of Ireland Galway (in the beautiful West of Ireland) and Director of the Health Research Board-Trial Methodology Research Network. He is an Editor with the Cochrane Pregnancy and Childbirth Group, an Associate Senior Lecturer with the UK Cochrane Centre and an author of numerous Cochrane systematic reviews predominantly in the field of fetal assessment. He has led a number of clinical trials recruiting from 100 to over 3000 participants and serves on a number of Trial Steering Committees and Data Monitoring Boards. He is a past member of the National Clinical Effectiveness Committee and the Midwives Committee of the Nursing and Midwifery Board of Ireland. He was a member of the Department of Health National Maternity Care Strategy Group (Ireland) and the Health Information and Quality Authority (HIQA) Maternity Standards Advisory Group (Ireland).
Electronic fetal monitoring (EFM) was introduced into widespread clinical practice in the 1970-80s on the premise that it would help detect abnormal fetal heart rate patterns thought to be associated with fetal hypoxia, and thereby allow earlier intervention to prevent fetal neurological damage or death. Despite the recognised limitations of EFM, it’s use has become ubiquitous particularly in high-income countries. In this presentation, Declan will be address the evidence underpinning the use of EFM and in particular the use of cardiotocography. His presentation will focus largely on findings from Cochrane systematic reviews related to aspects of fetal monitoring including how to read and interpret forest plots, which are a common means of presenting the findings of meta analyses of the effects of interventions on outcomes. Within his talk, Declan will highlight examples of discordance between evidence, practice and practice guidelines.
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