Document Detail


Impact of fetal blood sampling on vaginal delivery and neonatal outcome in deliveries complicated by pathologic fetal heart rate: a population based cohort study.
MedLine Citation:
PMID:  17140298     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the impact of electronic fetal monitoring (EFM) alone vs. EFM with additional fetal blood sampling (FBS) in vaginal deliveries complicated by pathologic fetal heart rate (FHR). METHODS: All deliveries in Hesse between 1990 and 2000 were evaluated for participation in this study. Inclusion criteria comprised (1) pathologic fetal heart rate, (2) singleton pregnancy, (3) cephalic presentation, (4) vaginal delivery, and (5) gestational age at delivery of more than 35 weeks' gestation. In order to analyze the meaning of additional risk factors at birth for the effectiveness of FBS two subgroups were selected depending on the presence of additional risk factors at birth. To examine the impact of FBS in deliveries with pathologic FHR on the mode of delivery and on neonatal outcome, univariate regression analysis was performed and odds ratios (OR) and their corresponding 95% confidence intervals (95% CI) were calculated. RESULTS: The study population comprised 49,560 deliveries, among deliveries complicated by pathologic FHR, 26% underwent FBS. Deliveries with pathologic FHR and controlled by FBS, with no additional antepartum risk factors, were associated with an increase in spontaneous births OR 1.41 (95% CI 1.27-1.58), and in the presence of additional risk factors OR 1.24 (1.19-1.30). Short-term neonatal outcome parameters were characterized by a lower frequency of severe fetal acidosis (umbilical artery pH <7.0) OR 0.55 (0.42-0.72), and Apgar score <5 after 5 min, OR 0.71 (0.55-0.90). CONCLUSION: In vaginal deliveries with pathologic FHR the use of FBS as an additional means of intrapartum fetal surveillance is associated with less vaginal operative deliveries, and with an improved short-term neonatal outcome.
Authors:
Werner Stein; Lars Hellmeyer; Björn Misselwitz; Stephan Schmidt
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Journal of perinatal medicine     Volume:  34     ISSN:  0300-5577     ISO Abbreviation:  J Perinat Med     Publication Date:  2006  
Date Detail:
Created Date:  2006-12-04     Completed Date:  2007-03-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0361031     Medline TA:  J Perinat Med     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  479-83     Citation Subset:  IM    
Affiliation:
Center of Gynecology and Obstetrics, University of Giessen and Marburg, Göttingen, Germany. werner.stein@med.uni-goettingen.de
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MeSH Terms
Descriptor/Qualifier:
Blood Chemical Analysis / methods
Cohort Studies
Delivery, Obstetric
Female
Fetal Blood*
Fetal Distress / blood,  diagnosis*
Fetal Monitoring / methods*
Gestational Age
Heart Rate, Fetal*
Humans
Infant, Newborn
Male
Pregnancy
Pregnancy Outcome
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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