Intrapartum oximetry of the fetus

East, Christine E. and Colditz, Paul B. (2007) Intrapartum oximetry of the fetus. Anesthesia and Analgesia, 105 Supp. 6: S59-S65. doi:10.1213/01.ane.0000268493.90073.f3


Author East, Christine E.
Colditz, Paul B.
Title Intrapartum oximetry of the fetus
Journal name Anesthesia and Analgesia   Check publisher's open access policy
ISSN 0003-2999
1526-7598
Publication date 2007-12-01
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1213/01.ane.0000268493.90073.f3
Volume 105
Issue Supp. 6
Start page S59
End page S65
Total pages 7
Place of publication Baltimore, MD, United States
Publisher Lippincott Williams & Wilkins Asia
Language eng
Subject 111006 Midwifery
1110 Nursing
Abstract Fetal monitoring during labor aims to identify fetal problems which, if uncorrected, may result in morbidity or death. A nonreassuring or abnormal fetal heart rate trace by cardiotocography (CTG) does not necessarily equate with fetal hypoxia and/or acidosis. However, in the absence of more objective data, the use of CTG often results in variable, but inappropriately high, operative delivery rates (forceps, vacuum, or cesarean delivery) for nonreassuring fetal status in many hospitals. The addition of fetal pulse oximetry (FPO) has the potential to improve the assessment of fetal well-being during labor. In this review we consider several aspects of FPO. Several factors, such as sensor to skin contact, uterine contractions, fetal hair, and caput succedaneum, influence the performance and use of FPO. Issues such as clinicians’ perspectives of FPO sensor placement, maternal perspectives of FPO during labor, and an economic analysis have all favored FPO. Several randomized controlled trials (RCTs) of FPO reported a reduction in cesarean delivery for nonreassuring fetal status when FPO was added to conventional CTG monitoring, with no difference in overall cesarean delivery rates. One large RCT reported no difference in mode of birth for any indication. Several issues relevant to the future of FPO have been addressed by these RCTs, the major issue being that it makes no difference to cesarean rates. It may be argued that FPO has a valid clinical use in monitoring the fetus with congenital heart block. Additionally, in situations of nonreassuring fetal status and dystocia, FPO may provide the necessary reassurance until adequate resources for cesarean delivery are available.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Excellence in Research Australia (ERA) - Collection
School of Nursing, Midwifery and Social Work Publications
 
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Created: Fri, 08 Jan 2010, 21:27:42 EST by Ms Lynette Adams on behalf of School of Nursing, Midwifery and Social Work