[Prevention of perinatal asphyxia. Can more be done by fetal monitoring?].
Intrapartum death has become a rare event since the introduction of electronic fetal monitoring (EFM). Randomized studies of EFM versus intermittent auscultation show that EFM reduces the risk of low Apgar score at birth and of neonatal seizures, although it may be possible to ensure low perinatal mortality even with intermittent auscultation alone. The rate of operative deliveries may increase with EFM, at least if scalp blood sampling is not used. Since scalp blood sampling is an invasive procedure providing only temporary information, the search goes on for new methods as complements to EFM. Fetal pulse oximetry and ST-analysis of fetal ECG (STAN) are two methods currently being tested in clinical studies. Regardless of the efficiency of monitoring methods that we may develop, there will always be a need for competent staff at our labor wards. Ongoing training of staff is necessary if asphyxia is to be avoided as far as possible.
Herbst
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Kvinnokliniken, Universitetssjukhuset i Lund.
D001034:Apgar Score; D001238:Asphyxia Neonatorum / Q000517:prevention & control*; D015148:Cardiotocography; D004562:Electrocardiography; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D005313:Fetal Death / Q000517:prevention & control; D005323:Fetal Monitoring / Q000379:methods / Q000639:trends; D006801:Humans; D007231:Infant, Newborn; D010092:Oximetry; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic