Fetal scalp blood sampling in labor – a review

Abstract

During the 1970s and 1980s, electronic fetal monitoring and fetal scalp blood sampling were introduced without robust evidence. With a methodical review of the published literature, and using one randomized controlled trial, seven controlled studies, nine randomized studies of various surveillance methods and data from the Danish National Birth Registry, we have assessed the usefulness of fetal scalp blood sampling as a complementary tool to improve the specificity and sensitivity of electronic cardiotocography. Based on heterogeneous studies of modest quality with somewhat inconsistent results, we conclude that fetal scalp blood sampling in conjunction with cardiotocography can reduce the risk of operative delivery. Fetal scalp blood sampling can provide additional information on fetal wellbeing and fetal reserves at a time before decisions are made concerning the need for and timing of operative delivery and the choice of anesthesia, and be an adjunct in the interpretation of cardiotocography patterns.

Craniofacial tissue oxygen saturation is associated with blood pH using an examiner’s finger-mounted tissue oximetry in mice

“…4 The results of this study demonstrate that the StO 2 and tissue blood pH in mice exhibit a strong positive correlation. Thus, the results of the present study support the conclusion of the previous report that StO 2 during labor is associated with umbilical arterial blood pH.…”

“…3 A meta-analysis reported that both FSBS and FHR monitoring during the intrapartum period resulted in avoiding unnecessary operative deliveries. 4 The National Institute for Health and Care Excellence recommends FSBS to assess fetal status when FHR monitoring yields a positive result. 5 Although FSBS is a good test for the management of labor, it is infrequently performed in clinical settings.…”

Point‐of‐care measurement of fetal blood lactate – Time to trust a new device

“…2 Consequently, such tests are popular and supported by national guidelines in many countries. [3][4][5] Lactate is a direct product of anaerobic glucose metabolism with animal studies demonstrating that levels rise earlier during hypoxia 6 and persist longer 7 than a low pH.…”

3D model simulation on magnetic induction spectroscopy for fetal acidosis detection using COMSOL multiphysics

“…Besides that, it helps to identify the suitable technique to deliver. Besides that, it helps to identify the suitable technique to deliver the baby, either by normal birth or caesarean method [4]- [5]. Conventional technique for this test requires the small incision on the fetal scalp and drop of blood is collected using a thin heparinized capillary tube [6].…”