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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| Veröffentlicht in: | The journal of obstetrics and gynaecology research 2018-12, Vol.44 (12), p.2127-2134 |
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| container_title | The journal of obstetrics and gynaecology research |
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| creator | Uchida, Toshiyuki Kanayama, Naohiro Kawai, Kenta Mukai, Mari Suzuki, Kazunao Itoh, Hiroaki Niwayama, Masatsugu |
| description | 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 |
| doi_str_mv | 10.1111/jog.13761 |
| format | Article |
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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.</description><identifier>ISSN: 1341-8076</identifier><identifier>EISSN: 1447-0756</identifier><identifier>DOI: 10.1111/jog.13761</identifier><identifier>PMID: 30084196</identifier><language>eng</language><publisher>Kyoto, Japan: John Wiley & Sons Australia, Ltd</publisher><subject>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</subject><ispartof>The journal of obstetrics and gynaecology research, 2018-12, Vol.44 (12), p.2127-2134</ispartof><rights>2018 Japan Society of Obstetrics and Gynecology</rights><rights>2018 Japan Society of Obstetrics and Gynecology.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4781-83f2f6cd686b8220965b59405f8c7d7d931f42bf4163ff9a70a8de387b2d4b393</citedby><cites>FETCH-LOGICAL-c4781-83f2f6cd686b8220965b59405f8c7d7d931f42bf4163ff9a70a8de387b2d4b393</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjog.13761$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjog.13761$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30084196$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Uchida, Toshiyuki</creatorcontrib><creatorcontrib>Kanayama, Naohiro</creatorcontrib><creatorcontrib>Kawai, Kenta</creatorcontrib><creatorcontrib>Mukai, Mari</creatorcontrib><creatorcontrib>Suzuki, Kazunao</creatorcontrib><creatorcontrib>Itoh, Hiroaki</creatorcontrib><creatorcontrib>Niwayama, Masatsugu</creatorcontrib><title>Reevaluation of intrapartum fetal monitoring using fetal oximetry: A review</title><title>The journal of obstetrics and gynaecology research</title><addtitle>J Obstet Gynaecol Res</addtitle><description>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.</description><subject>Acidosis</subject><subject>Cesarean section</subject><subject>Childbirth & labor</subject><subject>Delivery, Obstetric - methods</subject><subject>Delivery, Obstetric - standards</subject><subject>examiner's mounting probe</subject><subject>Female</subject><subject>Fetal monitoring</subject><subject>Fetal Monitoring - methods</subject><subject>Fetal Monitoring - standards</subject><subject>fetal pulse oximetry</subject><subject>Fetuses</subject><subject>Health risk assessment</subject><subject>Heart rate</subject><subject>Humans</subject><subject>near‐infrared spectroscopy</subject><subject>Obstetric Labor Complications - prevention & control</subject><subject>Oximetry - methods</subject><subject>Oximetry - standards</subject><subject>Oxygen</subject><subject>Pregnancy</subject><subject>REST protein</subject><subject>tissue oximetry</subject><issn>1341-8076</issn><issn>1447-0756</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kE9PwyAYh4nRuDk9-AVMEy962AaFAvW2LDr_LFli9ExoCwtLWya0m_v2Mjs9mMjh5c2bh19eHgAuERyhcMYruxwhzCg6An1ECBtCltDj0GOChhwy2gNn3q8gRCxF_BT0MIScoJT2wcurUhtZtrIxto6sjkzdOLmWrmmrSKtGllFla9NYZ-pl1Pp97cb201Sqcbu7aBI5tTFqew5OtCy9ujjcA_D-cP82fRzOF7On6WQ-zAnjYSGsY03zgnKa8TiGKU2yJCUw0TxnBStSjDSJM00QxVqnkkHJC4U5y-KCZDjFA3DT5a6d_WiVb0RlfK7KUtbKtl7E4XNp8MFRQK__oCvbujpsJ2JEgpkEJjRQtx2VO-u9U1qsnamk2wkExd5weLUU34YDe3VIbLNKFb_kj9IAjDtga0q1-z9JPC9mXeQX-EqD_w</recordid><startdate>201812</startdate><enddate>201812</enddate><creator>Uchida, Toshiyuki</creator><creator>Kanayama, Naohiro</creator><creator>Kawai, Kenta</creator><creator>Mukai, Mari</creator><creator>Suzuki, Kazunao</creator><creator>Itoh, Hiroaki</creator><creator>Niwayama, Masatsugu</creator><general>John Wiley & Sons Australia, Ltd</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TO</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201812</creationdate><title>Reevaluation of intrapartum fetal monitoring using fetal oximetry: A review</title><author>Uchida, Toshiyuki ; Kanayama, Naohiro ; Kawai, Kenta ; Mukai, Mari ; Suzuki, Kazunao ; Itoh, Hiroaki ; Niwayama, Masatsugu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4781-83f2f6cd686b8220965b59405f8c7d7d931f42bf4163ff9a70a8de387b2d4b393</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Acidosis</topic><topic>Cesarean section</topic><topic>Childbirth & labor</topic><topic>Delivery, Obstetric - methods</topic><topic>Delivery, Obstetric - standards</topic><topic>examiner's mounting probe</topic><topic>Female</topic><topic>Fetal monitoring</topic><topic>Fetal Monitoring - methods</topic><topic>Fetal Monitoring - standards</topic><topic>fetal pulse oximetry</topic><topic>Fetuses</topic><topic>Health risk assessment</topic><topic>Heart rate</topic><topic>Humans</topic><topic>near‐infrared spectroscopy</topic><topic>Obstetric Labor Complications - prevention & control</topic><topic>Oximetry - methods</topic><topic>Oximetry - standards</topic><topic>Oxygen</topic><topic>Pregnancy</topic><topic>REST protein</topic><topic>tissue oximetry</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Uchida, Toshiyuki</creatorcontrib><creatorcontrib>Kanayama, Naohiro</creatorcontrib><creatorcontrib>Kawai, Kenta</creatorcontrib><creatorcontrib>Mukai, Mari</creatorcontrib><creatorcontrib>Suzuki, Kazunao</creatorcontrib><creatorcontrib>Itoh, Hiroaki</creatorcontrib><creatorcontrib>Niwayama, Masatsugu</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The journal of obstetrics and gynaecology research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Uchida, Toshiyuki</au><au>Kanayama, Naohiro</au><au>Kawai, Kenta</au><au>Mukai, Mari</au><au>Suzuki, Kazunao</au><au>Itoh, Hiroaki</au><au>Niwayama, Masatsugu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Reevaluation of intrapartum fetal monitoring using fetal oximetry: A review</atitle><jtitle>The journal of obstetrics and gynaecology research</jtitle><addtitle>J Obstet Gynaecol Res</addtitle><date>2018-12</date><risdate>2018</risdate><volume>44</volume><issue>12</issue><spage>2127</spage><epage>2134</epage><pages>2127-2134</pages><issn>1341-8076</issn><eissn>1447-0756</eissn><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.</abstract><cop>Kyoto, Japan</cop><pub>John Wiley & Sons Australia, Ltd</pub><pmid>30084196</pmid><doi>10.1111/jog.13761</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1341-8076 |
| ispartof | The journal of obstetrics and gynaecology research, 2018-12, Vol.44 (12), p.2127-2134 |
| issn | 1341-8076 1447-0756 |
| language | eng |
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| source | MEDLINE; Wiley Online Library All Journals |
| 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 |
| title | Reevaluation of intrapartum fetal monitoring using fetal oximetry: A review |
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