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The effect of maternal posture on fetal cerebral oxygenation during labour
Author(s) -
Aldrich C. J.,
D'Antona D.,
Spencer J. A. D.,
Wyatt J. S.,
Peebles D. M.,
Delpy D. T.,
Reynolds E. O. R.
Publication year - 1995
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1995.tb09019.x
Subject(s) - supine position , oxygenation , medicine , fetus , anesthesia , cerebral blood volume , oxygen saturation , blood volume , cerebral blood flow , pregnancy , oxygen , chemistry , organic chemistry , biology , genetics
Objective To measure the effect of changes in maternal posture on fetal cerebral oxygenation during normal labour. Design A prospective study comparing changes in the fetal cerebral concentrations of oxy‐haemoglobin, deoxyhaemoglobin and cerebral blood volume, measured by near infrared spectroscopy, in women with effective epidural analgesia when moved from the left lateral to the supine position during labour. Setting A London teaching hospital obstetric unit. Subjects Fourteen women during uncomplicated labour at term. Results When compared with the left lateral position, the supine position was associated with a significant decrease in the mean concentration of fetal cerebral oxyhaemoglobin of 1.12 (SD 1.0, 95% CI 0.49 to 1.75) μmol. 100 g −1 ( P < 0 .01) without any significant change in the mean concentration of deoxyhaemoglobin and cerebral blood volume. These changes were associated with a significant decrease in the mean cerebral oxygen saturation of 8.3 (SD 8.8, 95% CI 1.5 to 15.1)% ( P < 0 .05, n = 9 ). Conclusion Changes in maternal posture during labour, in women with effective epidural analgesia, are associated with a significant decrease in fetal cerebral oxygenation.