Near-infrared spectroscopy of the placenta for monitoring fetal oxygenation during labour
Although being the golden standard for intrapartum fetal surveillance, cardiotocography (CTG) has been shown to have poor specificity for detecting fetal acidosis. Non-invasive near-infrared-spectroscopy (NIRS) monitoring of placental oxygenation during labour has not been studied yet. The objective...
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| description | Although being the golden standard for intrapartum fetal surveillance, cardiotocography (CTG) has been shown to have poor specificity for detecting fetal acidosis. Non-invasive near-infrared-spectroscopy (NIRS) monitoring of placental oxygenation during labour has not been studied yet. The objective of the study was to determine whether changes in placental NIRS values during labour could identify intrapartum fetal hypoxia and resulting acidosis. We included 43 healthy women in active stage of labour at term. CTG and NIRS parameters in groups with vs. without neonatal umbilical artery pH ≤ 7.20 were compared using Mann-Whitney-U. Receiver-operating-characteristics (ROC) curves were used to estimate predictive value of CTG and NIRS parameters for neonatal pH ≤ 7.20. A computer-based statistical classification was also performed to further evaluate predictive values of CTG and NIRS for neonatal acidosis. Ten (23%) neonates were born with umbilical artery pH ≤ 7.20. Compared to group with pH > 7.20, fetal acidosis was associated with more episodes of placental NIRS deoxygenation (9 (range 2-37) vs. 2 (range 0-65); p |
| doi_str_mv | 10.1371/journal.pone.0231461 |
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Non-invasive near-infrared-spectroscopy (NIRS) monitoring of placental oxygenation during labour has not been studied yet. The objective of the study was to determine whether changes in placental NIRS values during labour could identify intrapartum fetal hypoxia and resulting acidosis. We included 43 healthy women in active stage of labour at term. CTG and NIRS parameters in groups with vs. without neonatal umbilical artery pH ≤ 7.20 were compared using Mann-Whitney-U. Receiver-operating-characteristics (ROC) curves were used to estimate predictive value of CTG and NIRS parameters for neonatal pH ≤ 7.20. A computer-based statistical classification was also performed to further evaluate predictive values of CTG and NIRS for neonatal acidosis. Ten (23%) neonates were born with umbilical artery pH ≤ 7.20. Compared to group with pH > 7.20, fetal acidosis was associated with more episodes of placental NIRS deoxygenation (9 (range 2-37) vs. 2 (range 0-65); p<0.001), higher velocity of placental NIRS deoxygenation (2.31 (range 0-22) vs. 1 (range 0-49) %/s; p = 0.03), more decelerations on CTG (25 (range 3-91) vs. 10 (range 10-60); p = 0.02), and more prolonged decelerations on CTG (2 (range 0-4) vs. 1 (range 0-3); p = 0.04). Number of placental deoxygenations had the highest prognostic value for fetal/neonatal acidosis (area under the ROC curve 0.85 (95% confidence interval 0.70-0.99). Computer-based classification also identified number of placental deoxygenations as the most accurate classifier, with 25% false positive and 93% true positive rate in the training dataset, with 100% accuracy when applied to the testing dataset. Placental deoxygenations during labour measured by NIRS are associated with fetal/neonatal acidosis. Predictive value of placental NIRS for neonatal acidosis was superior to that of CTG.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0231461</identifier><identifier>PMID: 32298307</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acidosis ; Age ; Biology and Life Sciences ; Cerebral palsy ; Childbirth & labor ; Classification ; Clinical medicine ; Confidence intervals ; Datasets ; Deceleration ; Deoxygenation ; Fetuses ; Gynecology ; Health surveillance ; Hypoxia ; I.R. radiation ; Infrared spectra ; Infrared spectroscopy ; Medicine and Health Sciences ; Menstruation ; Monitoring ; Near infrared radiation ; Near infrared spectroscopy ; Neonates ; Newborn babies ; Obstetrics ; Oxygenation ; Parameters ; pH effects ; Physical Sciences ; Placenta ; Pregnancy ; Research and Analysis Methods ; Spectrum analysis ; Statistical analysis ; Surveillance ; Ultrasonic imaging ; Womens health</subject><ispartof>PloS one, 2020-04, Vol.15 (4), p.e0231461-e0231461</ispartof><rights>2020 Ražem et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Ražem et al 2020 Ražem et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c526t-d0ae79c6ac956b0345e0650cca3f396d92b263505afd28064caed8998503ebb93</citedby><cites>FETCH-LOGICAL-c526t-d0ae79c6ac956b0345e0650cca3f396d92b263505afd28064caed8998503ebb93</cites><orcidid>0000-0002-1221-946X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7162483/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7162483/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32298307$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Palatnik, Anna</contributor><creatorcontrib>Ražem, Katja</creatorcontrib><creatorcontrib>Kocijan, Juš</creatorcontrib><creatorcontrib>Podbregar, Matej</creatorcontrib><creatorcontrib>Lučovnik, Miha</creatorcontrib><title>Near-infrared spectroscopy of the placenta for monitoring fetal oxygenation during labour</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Although being the golden standard for intrapartum fetal surveillance, cardiotocography (CTG) has been shown to have poor specificity for detecting fetal acidosis. Non-invasive near-infrared-spectroscopy (NIRS) monitoring of placental oxygenation during labour has not been studied yet. The objective of the study was to determine whether changes in placental NIRS values during labour could identify intrapartum fetal hypoxia and resulting acidosis. We included 43 healthy women in active stage of labour at term. CTG and NIRS parameters in groups with vs. without neonatal umbilical artery pH ≤ 7.20 were compared using Mann-Whitney-U. Receiver-operating-characteristics (ROC) curves were used to estimate predictive value of CTG and NIRS parameters for neonatal pH ≤ 7.20. A computer-based statistical classification was also performed to further evaluate predictive values of CTG and NIRS for neonatal acidosis. Ten (23%) neonates were born with umbilical artery pH ≤ 7.20. 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Predictive value of placental NIRS for neonatal acidosis was superior to that of CTG.</description><subject>Acidosis</subject><subject>Age</subject><subject>Biology and Life Sciences</subject><subject>Cerebral palsy</subject><subject>Childbirth & labor</subject><subject>Classification</subject><subject>Clinical medicine</subject><subject>Confidence intervals</subject><subject>Datasets</subject><subject>Deceleration</subject><subject>Deoxygenation</subject><subject>Fetuses</subject><subject>Gynecology</subject><subject>Health surveillance</subject><subject>Hypoxia</subject><subject>I.R. radiation</subject><subject>Infrared spectra</subject><subject>Infrared spectroscopy</subject><subject>Medicine and Health Sciences</subject><subject>Menstruation</subject><subject>Monitoring</subject><subject>Near infrared radiation</subject><subject>Near infrared spectroscopy</subject><subject>Neonates</subject><subject>Newborn 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ražem, Katja</au><au>Kocijan, Juš</au><au>Podbregar, Matej</au><au>Lučovnik, Miha</au><au>Palatnik, Anna</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Near-infrared spectroscopy of the placenta for monitoring fetal oxygenation during labour</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2020-04-16</date><risdate>2020</risdate><volume>15</volume><issue>4</issue><spage>e0231461</spage><epage>e0231461</epage><pages>e0231461-e0231461</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Although being the golden standard for intrapartum fetal surveillance, cardiotocography (CTG) has been shown to have poor specificity for detecting fetal acidosis. Non-invasive near-infrared-spectroscopy (NIRS) monitoring of placental oxygenation during labour has not been studied yet. The objective of the study was to determine whether changes in placental NIRS values during labour could identify intrapartum fetal hypoxia and resulting acidosis. We included 43 healthy women in active stage of labour at term. CTG and NIRS parameters in groups with vs. without neonatal umbilical artery pH ≤ 7.20 were compared using Mann-Whitney-U. Receiver-operating-characteristics (ROC) curves were used to estimate predictive value of CTG and NIRS parameters for neonatal pH ≤ 7.20. A computer-based statistical classification was also performed to further evaluate predictive values of CTG and NIRS for neonatal acidosis. Ten (23%) neonates were born with umbilical artery pH ≤ 7.20. Compared to group with pH > 7.20, fetal acidosis was associated with more episodes of placental NIRS deoxygenation (9 (range 2-37) vs. 2 (range 0-65); p<0.001), higher velocity of placental NIRS deoxygenation (2.31 (range 0-22) vs. 1 (range 0-49) %/s; p = 0.03), more decelerations on CTG (25 (range 3-91) vs. 10 (range 10-60); p = 0.02), and more prolonged decelerations on CTG (2 (range 0-4) vs. 1 (range 0-3); p = 0.04). Number of placental deoxygenations had the highest prognostic value for fetal/neonatal acidosis (area under the ROC curve 0.85 (95% confidence interval 0.70-0.99). Computer-based classification also identified number of placental deoxygenations as the most accurate classifier, with 25% false positive and 93% true positive rate in the training dataset, with 100% accuracy when applied to the testing dataset. Placental deoxygenations during labour measured by NIRS are associated with fetal/neonatal acidosis. Predictive value of placental NIRS for neonatal acidosis was superior to that of CTG.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>32298307</pmid><doi>10.1371/journal.pone.0231461</doi><orcidid>https://orcid.org/0000-0002-1221-946X</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Acidosis Age Biology and Life Sciences Cerebral palsy Childbirth & labor Classification Clinical medicine Confidence intervals Datasets Deceleration Deoxygenation Fetuses Gynecology Health surveillance Hypoxia I.R. radiation Infrared spectra Infrared spectroscopy Medicine and Health Sciences Menstruation Monitoring Near infrared radiation Near infrared spectroscopy Neonates Newborn babies Obstetrics Oxygenation Parameters pH effects Physical Sciences Placenta Pregnancy Research and Analysis Methods Spectrum analysis Statistical analysis Surveillance Ultrasonic imaging Womens health |
| title | Near-infrared spectroscopy of the placenta for monitoring fetal oxygenation during labour |
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