Reevaluation of intrapartum fetal monitoring using fetal oximetry: A review

Aim Although several studies reported the measurement of fetal oxygen saturation using fetal pulse oximetry (FPO) for evaluation of the fetal intrapartum condition, a systematic review of the seven randomized controlled trials (RCTs) provided no evidence to support FPO for intrapartum fetal monitori...

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Published in:The journal of obstetrics and gynaecology research 2018-12, Vol.44 (12), p.2127-2134
Main Authors: Uchida, Toshiyuki, Kanayama, Naohiro, Kawai, Kenta, Mukai, Mari, Suzuki, Kazunao, Itoh, Hiroaki, Niwayama, Masatsugu
Format: Article
Language:English
Subjects:
Acidosis
Cesarean section
Childbirth & labor
Delivery, Obstetric - methods
Delivery, Obstetric - standards
examiner's mounting probe
Female
Fetal monitoring
Fetal Monitoring - methods
Fetal Monitoring - standards
fetal pulse oximetry
Fetuses
Health risk assessment
Heart rate
Humans
near‐infrared spectroscopy
Obstetric Labor Complications - prevention & control
Oximetry - methods
Oximetry - standards
Oxygen
Pregnancy
REST protein
tissue oximetry
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Summary:Aim Although several studies reported the measurement of fetal oxygen saturation using fetal pulse oximetry (FPO) for evaluation of the fetal intrapartum condition, a systematic review of the seven randomized controlled trials (RCTs) provided no evidence to support FPO for intrapartum fetal monitoring. In the present review, we re‐evaluate an overview for the use of FPO and seven RCTs of FPO. Methods We reviewed numerous previous reports on FPO and seven RCTs of intrapartum FPO. RCTs were conducted with the main outcome measure being a reduction in the cesarean section rate. Results The largest trial with 5341 entries failed to show any reduction. The negative result from this RCT may be explained by the use of a different cutoff value for fetal oxygen saturation compared to the other RCT; in addition, there were differences in the indications for cesarean section due to dystocia and in the definition of non‐reassuring fetal status (NRFS). An abnormal FPO value, defined as the fetal oxygen saturation value
ISSN:1341-8076
1447-0756
DOI:10.1111/jog.13761