Fetal pulse oximetry for fetal assessment in labour

East, Christine; Chan, Felix Hon-Wai; Colditz, P. B.

doi:10.1002/14651858.cd004075.pub2

Cited by 23 publications

(10 citation statements)

References 24 publications

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“…East et al have reported that during the active phase of labor, every method has a significant rate of signal loss and the loss of sensor contact occurred up to 64% of time with oximetry. 6 Another drawback of this transvaginal procedure is that the probe often moves away from the fetal head during delivery, which may lead to an intrauterine infection caused by rupture of the gestational sac. Furthermore, these methods are essentially invasive, as the probe is inserted into the uterine cervix only after the rupture of the gestational sac.…”

Section: Introductionmentioning

confidence: 99%

Examiner’s finger-mounted fetal tissue oximetry

Kanayama

Niwayama

2014

J. Biomed. Opt

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Abstract. The best way to assess fetal condition is to observe the oxygen status of the fetus (as well as to assess the condition of infants, children, and adults). Previously, several fetal oximeters have been developed; however, no instrument has been utilized in clinical practice because of the low-capturing rate of the fetal oxygen saturation. To overcome the problem, we developed a doctor's finger-mounted fetal tissue oximeter, whose sensor volume is one hundredth of the conventional one. Additionally, we prepared transparent gloves. The calculation algorithm of the hemoglobin concentration was derived from the light propagation analysis based on the transport theory. We measured neonatal and fetal oxygen saturation (StO 2 ) with the new tissue oximeter. Neonatal StO 2 was measured at any position of the head regardless of amount of hair. Neonatal StO 2 was found to be around 77%. Fetal StO 2 was detected in every position of the fetal head during labor regardless of the presence of labor pain. Fetal StO 2 without labor pain was around 70% in the first stage of labor and around 60% in the second stage of labor. We concluded that our new concept of fetal tissue oximetry would be useful for detecting fetal StO 2 in any condition of the fetus.

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Section: Introductionmentioning

confidence: 99%

Examiner’s finger-mounted fetal tissue oximetry

Kanayama

Niwayama

2014

J. Biomed. Opt

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“…There have been numerous studies with conflicting findings on the predictive value of SpO 2 in adult and pediatric populations. [4][5][6][7][8][9] While there are limited data related to a normal range in pregnancy against which to measure physiological perturbations, a suggested normal value for SpO 2 in pregnancy is ≥ 97%. 10 The ability of maternal SpO 2 to predict adverse maternal outcomes has been poorly studied, and in the few studies of the subject the definitions of oxygen desaturation events are inconsistent.…”

Section: Introductionmentioning

confidence: 99%

Oxygen Saturation as a Predictor of Adverse Maternal Outcomes in Women with Preeclampsia

Millman

Payne

et al. 2011

Journal of Obstetrics and Gynaecology Canada

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Objective: We sought to determine the role of respiratory assessment by cardiorespiratory symptoms and/or oxygen saturation by pulse oximetry (SpO 2 ) in predicting adverse maternal outcomes in women admitted to hospital with preeclampsia .Methods: These data derive from an international, prospective multicentre cohort study, PIERS (Pre-eclampsia Integrated Estimate of RiSk), which assesses predictors of adverse outcomes in women admitted to tertiary perinatal units with preeclampsia . Univariate and multivariate analyses of cardiorespiratory symptoms and pulse oximetry were performed to assess their ability to predict a combined adverse maternal outcome developed through international Delphi consensus .Results: SpO 2 successfully predicted adverse maternal outcomes; the area under the receiver-operator characteristic curve (AUC ROC) was 0 .71 (95% CI 0 .65 to 0 .77) . Combining the symptoms of chest pain and/or dyspnea with pulse oximetry improved this predictive ability (AUC ROC 0 .73; 95% CI 0 .67 to 0 .78) . When SpO 2 was stratified into risk groups using inflection points on the ROC curve, the highest risk group (SpO 2 90% to 93%) had an odds ratio of 18 .1 (95% CI 8 .2 to 40 .2) for all outcomes within 48 hours when compared with the baseline group (SpO 2 98% to 100%) . Conclusion:Assessing SpO 2 aids in the assessment of maternal risk in women admitted to hospital with preeclampsia . An SpO 2 value of ≤ 93% confers particular risk . The symptom complex of chest pain and/or dyspnea adds to the association . RésuméObjectif : Nous avons cherché à déterminer le rôle de l'évaluation respiratoire en fonction des symptômes cardiorespiratoires et/ou celui de la détermination de la saturation en oxygène par oxymétrie pulsée (SaO 2 ) dans la prédiction des issues maternelles indésirables chez les femmes hospitalisées en raison d'une prééclampsie . Méthodes :Ces données sont issues de l'étude de cohorte multicentrique prospective internationale PIERS (Pre-eclampsia Integrated Estimate of RiSk), laquelle a évalué les facteurs prédictifs des issues indésirables chez les femmes admises dans des unités périnatales tertiaires en raison d'une prééclampsie . Des analyses univariées et multivariées des symptômes cardiorespiratoires et de l'oxymétrie pulsée ont été menées pour en évaluer la capacité de prédire une issue maternelle indésirable combinée, élaborée par consensus Delphi international .Résultats : La SaO 2 a permis de prédire avec succès les issues maternelles indésirables; la surface sous la courbe de la fonction d'efficacité de l'observateur-opérateur (AUC ROC) était de 0,71 (IC à 95 %, 0,65 -0,77) . Le fait de combiner les symptômes de la douleur thoracique et/ou de la dyspnée à l'oxymétrie pulsée a entraîné l'amélioration de cette capacité de prédiction (AUC ROC, 0,73; IC à 95 %, 0,78

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“…Fetal pulse oximetry was developed in the 1990s, but the commercialization of electrodes has subsequently been discontinued. A systematic review of four trials comparing CTG + fetal pulse oximetry with isolated CTG showed no difference in the overall cesarean delivery rate (relative risk [RR] 0.99; 95% CI, 0.86-1.13), while adverse fetal outcomes were rare in both groups [4]. The present chapter focuses on the adjunctive technologies currently available for intrapartum fetal monitoring.…”

Section: Introductionmentioning

confidence: 96%