The association between uterine contraction frequency and fetal scalp pH in women with suspicious or pathological fetal heart rate tracings: A retrospective study

Frenken, Maria W.E.; Woude, Daisy A.A. van der; Dieleman, Jeanne P.; Oei, S.G.; Laar, Judith O E H van

doi:10.1016/j.ejogrb.2022.01.023

Cited by 3 publications

(7 citation statements)

References 30 publications

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“…Similarly, another recent study published by Frenken et al [ 25 ] connected the frequency of uterine contractions with the fetal scalp pH. The study was a retrospective one, spanned over 5 years, between 2015 and 2020, and included 765 women with abnormal fetal heart rate.…”

Section: Resultsmentioning

confidence: 99%

“…An actual upgrade of the technique was developed by Uchida et al [ 25 ] in 2016. Since traditional fetal scalp blood sampling is disregarded by obstetricians due to its invasiveness, the researchers created a miniaturized, portable oximeter (fabricated using a flexible substrate with two LEDs, and two photodiodes adhered to a black rubber sheet) with the sensor attached to the examiners’ index finger.…”

Section: Resultsmentioning

confidence: 99%

“…That is why this technique was abandoned in the USA. However, recent studies in Finland and Sweden show that fetal blood sampling can reduce the number of unnecessary caesarian sections by actively determining the presence of acidemia [ 24 , 25 ]…”

Section: Resultsmentioning

confidence: 99%

“…In this respect, the field of engineered nanomedicines, which include polymeric nanoparticles, liposomes, dendrimers, peptide-drug conjugates or viral vectors that have the advantage of being easily modifiable, targetable and miniaturized in terms of size, shape and surface chemistry to the needs of the perinatal care. Since fetal scalp blood sampling is still under research and randomized controlled trial, which compares the relevance of pH and lactates to the obstetrical situation, the maternal-fetal medicine could greatly benefit from the introduction of engineered nanomedicines to the field [ 25 , 51 ].…”

Section: Resultsmentioning

confidence: 99%

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Current Innovative Methods of Fetal pH Monitoring—A Brief Review

Bohîlțea

Mihai²,

Ducu³

et al. 2022

Diagnostics

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In this study, we explore the “why?”, and “how?”, monitoring the pH of the fetal scalp is used, and show its limitations. In addition, we review the development of new devices based on the modern physics and nanomaterials serving this topic. Most of the works we found in our search have focused on improving the prognostic of fetal heart rate monitoring, because it is the “golden standard” in determining fetal distress. Although the best-known screening method, it can only provide limited information about the actual status of the fetus. The best predictive assessment, with the highest reproducibility, states that a normal fetal heart rate is indicative of a healthy baby. However, its excellent sensitivity is much reduced when identifying the actual “distress”. This is when second-line monitoring methods come into play to guide the diagnostics and direct the obstetrician towards an action plan. Although a historic method, fetal scalp pH sampling is still under review as to its efficiency and place in the current obstetrics. Continuous surveillance of the fetal parameters is important, especially for the fetuses undergoing intrauterine growth restricted (IUGR). Since fetal scalp blood sampling is still under research and is a randomized controlled trial, which compares the relevance of pH and lactates to the obstetrical situation, the maternal-fetal medicine could greatly benefit from the introduction of engineered nanomedicines to the field.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Current Innovative Methods of Fetal pH Monitoring—A Brief Review

Bohîlțea

Mihai²,

Ducu³

et al. 2022

Diagnostics

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“…According to the FIGO and ACOG guidelines, five contractions every 10 min averaged over 30 min is considered the upper limit of normal uterine activity 6,7 . Frequency exceeding five contractions is defined as tachysystole, although recent studies suggest that the maximum frequency of contractions every 10 min should be four rather than five 8,9 . Interventions to reduce contraction frequency are recommended in the case of fetal heart rate abnormalities, although these guidelines 6,7 provide scarce clinical data to support the deleterious effects of tachysystole.…”

Section: Introductionmentioning

confidence: 99%

Uterine contractile activity and neonatal outcome – A blind analysis of a randomized controlled trial cohort

Juhantalo,

Hautakangas,

Palomäki

et al. 2024

Acta Obstet Gynecol Scand

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IntroductionSufficient contractions are necessary for a successful delivery but each contraction temporarily constricts the oxygenated blood flow to the fetus. Individual fetal or placental characteristics determine how the fetus can withstand this temporary low oxygen saturation. However, only a few studies have examined the impact of uterine activity on neonatal outcome and even less attention has been paid to parturients’ individual characteristics. Our objective was therefore to find out whether fetuses compromised by maternal or intrapartum risk factors are more vulnerable to excessive uterine activity.Material and methodsUterine contractile activity was assessed by intrauterine pressure catheters. Women (n = 625) with term singleton pregnancies and fetus in cephalic presentation were included in this secondary, blind analysis of a randomized controlled trial cohort. Intrauterine pressure as Montevideo units (MVU), contraction frequency/10 min and uterine baseline tone were calculated for 4 h prior to birth or the decision to perform cesarean section. Uterine activity in relation to umbilical artery pH linearly or ≤7.10 was used as the primary outcome. Need for operative delivery (either cesarean section or vacuum‐assisted delivery) due to fetal distress was analyzed as a secondary outcome. In addition, belonging to vulnerable subgroups with, for example, chorioamnionitis, hypertensive or diabetic disorders, maternal smoking or neonatal birthweight <10th percentile were investigated as additional risk factors.ResultsA linear decline in umbilical artery pH was seen with increasing intrauterine pressure in all deliveries (p < 0.001). Among parturients with suspected chorioamnionitis, every increasing 10 MVUs increased the likelihood of umbilical artery pH ≤7.10 (odds ratio [OR] 1.17, 95% confidence interval [CI] 1.02–1.34, p = 0.023). The need for operative delivery due to fetal distress was increased among all laboring women by every increasing 10 MVUs (OR 1.05, 95% CI 1.01–1.09, p = 0.015). This association with operative deliveries was further increased among parturients with hypertensive disorders (OR 1.23, 95% CI 1.05–1.43, p = 0.009) and among those with diabetic disorders (OR 1.13, 95% CI 1.04–1.28, p = 0.003).ConclusionsIncreasing intrauterine pressure impairs umbilical artery pH especially among parturients with suspected chorioamnionitis. Fetuses in pregnancies affected by chorioamnionitis, hypertensive or diabetic disorders are more vulnerable to high intrauterine pressure.

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