Fetal pulse oximetry and neonatal outcome

ABSTRACT

The purpose of this study was to compare the predictive value of intrapartum fetal pulse oximetry with that of fetal blood analysis for an abnormal neonatal outcome in case of abnormal feta heart rate. Fetal oxygen saturation was continuously monitored with Nellcor N-400 fetal pulse oximeter in case of an abnormal fetal heart rate during labor. Simultaneous readings of fetal heart rate and fetal blood analysis obtained before birth were compared with neonatal status. Abnormal neonatal outcome was defined as umbilical arterial pHApgar score<7, transfer to neonatal intensive care unit and/or neonatal death. At a 7.20 threshold for fetal scalp pH and 30%forfetal oxygen saturation [10th centile in the study population], the predictive value of fetal pulse oximetry was similar to that of fetal blood analysis for an arterial umbilical pH 7.15 and for an abnormal neonatal outcome. The receiver-operator characteristic curve showed similar performance of either technique for cutoff valuefetal blood pH and<30% for fetal oxygen saturation whereas fetal pulse oximetry became superior at higher thresholds. We concluded that the predictive value of fetal pulse oximetry could be favorably compared with that of fetal blood analysis: