Fetal Blood Monitoring Is Pointless

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Main Category: Pregnancy / Obstetrics
Also Included In: Blood / Hematology;  Women's Health / Gynecology;  Pediatrics / Children's Health
Article Date: 23 Nov 2006 - 10:00 PDT

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The OxiFirst Fetal Oxygen Saturation Monitoring System, a test which checks how much oxygen is in fetal blood before delivery, was found to have no impact on whether a C-section was needed, neither did it have any bearing in the health of the newborn baby, say researchers from the U.S. National Institute of Child Health and Human Development's Maternal/Fetal Medicine Units Network. The researchers concluded there are no compelling reasons to use this new technology.

You can read about this study in the New England Journal of Medicine (NEJM).

Lead author, Dr. Steven Bloom, said "Given the available evidence, and I believe we are the most definitive study, there is no apparent benefit of this technology, which is not to say there won't be possibilities in the future."

Monitoring oxygen in fetal blood is not widely used in the USA, while electronic fetal monitoring is. The OxiFirst Fetal Oxygen Saturation Monitoring System was approved by the FDA in 2000 as a complement to electronic fetal monitoring. It was thought, at the time, as a useful device for preventing cerebral palsy. Cerebral palsy is believed to be caused by oxygen deprivation during delivery. However, as this study showed no difference in cerebral palsy rates, the condition is more likely to develop earlier on during the pregnancy.

In this study the researchers looked at 5,341 deliveries - all the mothers were having their first baby. They were divided into two groups. In one group the health professionals were able to see fetal oxygen saturation values. In the other group, the values were recorded, but the health professionals could not see them.

They found no significant difference in the number of C-section deliveries between the two groups. 26.3% of deliveries ended up as C-sections in the group where doctors could see the oxygen saturation values, compared to 27.5% in the other group. The study was supposed to continue so that 10,000 deliveries were observed. However, it was stopped because the results were so evident.

The researchers concluded that knowledge of fetal oxygen saturation does not bring about a reduction in the number of cesarean deliveries, neither does it improve the condition of the newborn.

"Fetal Pulse Oximetry and Cesarean Delivery"
Steven L. Bloom, M.D., Catherine Y. Spong, M.D., Elizabeth Thom, Ph.D., Michael W. Varner, M.D., Dwight J. Rouse, M.D., Sandy Weininger, Ph.D., Susan M. Ramin, M.D., Steve N. Caritis, M.D., Alan Peaceman, M.D., Yoram Sorokin, M.D., Anthony Sciscione, M.D., Marshall Carpenter, M.D., Brian Mercer, M.D., John Thorp, M.D., Fergal Malone, M.D., Margaret Harper, M.D., Jay Iams, M.D., Garland Anderson, M.D., for the National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network
NEJM Volume 355:2195-2202 November 23, 2006 Number 21
http://content.nejm.org/cgi/content/short/355/21/2195

Written by: Christian Nordqvist
Editor: Medical News Today
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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