| Is intrapartum fetal blood sampling a gold standard diagnostic tool for fetal distress? | |
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MedLine Citation:
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PMID: 21300427 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Developed in 1960s, cardiotocography is a screening test and fetal blood sampling (FBS) is an adjunctive, diagnostic technique to detect fetal hypoxia. A fetal blood sample pH value of less than 7.20 has a higher specificity than a pathological CTG to predict low Apgar score at 1 min. Though with a pathological CTG and despite a normal FBS pH value the risk of delivering a hypoxic infant is 30-50%, FBS has assumed considerable importance in purportedly reducing unnecessary obstetric intervention. The evidence for this is weak: the use of FBS with CTG has been shown to reduce operative vaginal deliveries though not Caesarean sections due to fetal distress. There is no difference in the umbilical artery pH at delivery with the use of intermittent FBS with CTG compared to CTG alone. FBS is an invasive procedure: obtaining an adequate blood sample is often difficult and the pH results are affected by handling of the sample, aerobic contamination and processing. Validation of intrapartum FBS requires that the pH and other values obtained are compared to a 'gold standard' technique. Although FBS has been compared to other tests such as scalp lactate, pulse oximetry, fetal ECG waveform analysis, and central haemodynamics in labouring rhesus monkeys, none of these can be considered as 'gold standard'. In the light of the existing evidence, the role of intrapartum FBS as a gold standard diagnostic technique is unproven. |
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Authors:
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Amita A Mahendru; Christoph C Lees |
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Publication Detail:
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Type: Journal Article Date: 2011-02-05 |
Journal Detail:
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Title: European journal of obstetrics, gynecology, and reproductive biology Volume: 156 ISSN: 1872-7654 ISO Abbreviation: Eur. J. Obstet. Gynecol. Reprod. Biol. Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-06-13 Completed Date: 2011-10-24 Revised Date: 2012-04-13 |
Medline Journal Info:
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Nlm Unique ID: 0375672 Medline TA: Eur J Obstet Gynecol Reprod Biol Country: Ireland |
Other Details:
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Languages: eng Pagination: 137-9 Citation Subset: IM |
Copyright Information:
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Copyright © 2011 Elsevier Ireland Ltd. All rights reserved. |
Affiliation:
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Clinical Research Fellow in Fetal Medicine, Rosie Maternity-Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 2QQ, UK. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cardiotocography Female Fetal Blood / chemistry* Fetal Distress / diagnosis* Fetal Hypoxia / diagnosis* Humans Pregnancy |
| Comments/Corrections | |
Comment In:
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Eur J Obstet Gynecol Reprod Biol. 2012 Mar;161(1):114; author reply 114-5
[PMID:
22000997
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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