Multicenter study on the clinical value of fetal pulse oximetry

Objective: Our purpose was to evaluate the feasibility of intrapartum fetal pulse oximetry, the distribution of fetal oxygen saturation values, and the relationship with the neonatal outcome in a population with an abnormal fetal heart rate. Study Design: A prospective multicenter observational stud...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 1997-11, Vol.177 (5), p.1238-1246
Main Authors: Goffinet, François, Langer, Bruno, Carbonne, Bruno, Berkane, Nadia, Tardif, Didier, Le Goueff, Françoise, Laville, Marc, Maillard, Françoise
Format: Article
Language:English
Subjects:
Biological and medical sciences
Delivery. Postpartum. Lactation
fetal blood analysis
Fetal pulse oximetry
fetal surveillance
Gynecology. Andrology. Obstetrics
labor
Maternal, fetal and perinatal monitoring
Medical sciences
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Summary:Objective: Our purpose was to evaluate the feasibility of intrapartum fetal pulse oximetry, the distribution of fetal oxygen saturation values, and the relationship with the neonatal outcome in a population with an abnormal fetal heart rate. Study Design: A prospective multicenter observational study was performed from June 1994 to November 1995. Fetal oxygen saturation was continuously recorded with use of a Nellcor N-400 fetal pulse oximeter in case of an abnormal fetal heart rate during labor. Simultaneous readings of fetal oxygen saturation and fetal blood analysis were obtained at inclusion and before birth. Feasibility, adverse effects, distribution of fetal oxygen saturation values, and relationship with neonatal outcome were assessed. Results: One hundred seventy-four patients were included. From 172 attempted sensor placements, the procedure was impossible in three cases and fetal oxygen saturation values were obtained in 164 cases (95.3%). Physicians considered sensor placement an easier task than an attempt at fetal blood analysis (easy in 87.5% vs 78.9% for fetal blood analysis, p = 0.03). The mean reliable signal time (±SD) was 64.7% ± 32% during the first stage. There were no serious adverse effects in the study population. The mean fetal oxygen saturation during the first stage of labor was 42.2% ± 8.0% (10th to 90th percentile range 30% to 53%). Fetal oxygen saturation was significantly correlated with scalp pH ( r = 0.29, p = 0.01) but not with neonatal umbilical artery pH or gas values. There was a significant association between low fetal oxygen saturation (
ISSN:0002-9378
1097-6868
DOI:10.1016/S0002-9378(97)70045-0