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Reevaluation of intrapartum fetal monitoring using fetal oximetry: A review
Author(s) -
Uchida Toshiyuki,
Kanayama Naohiro,
Kawai Kenta,
Mukai Mari,
Suzuki Kazunao,
Itoh Hiroaki,
Niwayama Masatsugu
Publication year - 2018
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.13761
Subject(s) - medicine , randomized controlled trial , fetus , oxygen saturation , obstetrics , surgery , pregnancy , oxygen , chemistry , genetics , organic chemistry , biology
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.