Reevaluation of intrapartum fetal monitoring using fetal oximetry: A review.
J Obstet Gynaecol Res
; 44(12): 2127-2134, 2018 Dec.
Article
em En
| MEDLINE
| ID: mdl-30084196
ABSTRACT
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 <30% for at least 10 min, is useful for making a diagnosis of fetal acidosis. A newly developed device, an examiner's finger-mounted tissue oximetry, accurately measures tissue oxygen saturation while overcoming the drawbacks of FPO, such as infection risk and slipping off of the sensor during descent of the fetal head.CONCLUSION:
FPO (including the new device) with fetal heart rate monitoring in selected cases of NRFS may reduce the cesarean section rate.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Oximetria
/
Parto Obstétrico
/
Monitorização Fetal
/
Complicações do Trabalho de Parto
Tipo de estudo:
Clinical_trials
/
Systematic_reviews
Limite:
Female
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Humans
/
Pregnancy
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article