Current Methods to monitor labour progression in the UK: A Scoping Review Protocol

Background Prolonged labour remains a considerable cause of maternal and perinatal morbidity and mortality on both a national and global scale. Current methods to monitor labour progression in the UK are largely outdated and constrained by arbitrary scales, allowing for a large degree of uncertainty and inter-observer variability. This leads to a high rate of both under- and over diagnosis of prolonged labour in women and in turn significantly increases the risk to both mother and foetus. Aim To identify current methods used to labour progression and diagnose pathologically prolonged labour in UK clinical practice, and their associated limitations. We also aim to identify potential priorities for future research in order to improve safety outcomes for women and babies. Methods This review adhered to the Joanna Briggs Institute methodology for scoping reviews and PRISMA-ScR checklist. A systematic search was conducted across 3 databases: EMBASE (Ovid), PubMed, and the Cochrane Library. Pre-defined search terms relating to intrapartum monitoring were used. A three-step search strategy, including background citation searching, will be performed. Study selection, data extraction and analysis will be conducted independently by two or more reviewers using EndNote and Rayyan software. Included studies will be collated in tabular format, with a narrative synthesis. Expected Results The mainstay of labour monitoring in UK maternity units comprises of routine vaginal examinations, charting tools such as use of the partogram, and emerging digital technologies such as point-of-care intermittent transabdominal and transperineal ultrasound imaging. The review will highlight common practice and associated limitations in UK obstetric practice, and inform future research priorities to improve obstetric monitoring. Keywords: Labour progression, labour monitoring, intrapartum ultrasound