[The usefulness of the intrapartum fetal pulse oximetry in anticipating the neonatal outcome].
OBJECTIVE
The aim of the study was to evaluate the usefulness of the intrapartum fetal pulse oximetry in anticipating the neonatal outcome.


METHODS
The saturation of the fetal blood (SpO2) was measured during labor with non-invasive pulse oximeter designed for fetal application. The average, minimum and maximum SpO2 were evaluated separately for the first and the second stage of labor. The average SpO2 of the fetus was compared to neonatal condition assessed by umbilical vein pH, pO2 and pCO2 and according to Apgar score.


RESULTS
Twenty patients have been monitored with fetal pulse oximetry. All those patients had normal vaginal delivery. During the first stage of labor, the average fetal SpO2 was 51.94 +/- 8.03%, the minimum SpO2 was 38.35 +/- 9.15%, and the maximum SpO2 was 63.35 +/- 7.75%; in the second stage of labor average fetal SpO2 was 43.82 +/- 7.16%, minimum SpO2 was 34.35 +/- 7.79% and the maximum SpO2 was 50.94 +/- 8.37%. A significant decrease in fetal average and maximum SpO2 occurred from stage I to stage II of labor (average SpO2: 51.94 +/- 8.03% vs. 43.82 +/- 7.16%, p = 0.0002; maximum SpO2: 63.35 +/- 7.75% vs. 50.94 +/- 8.37%, p < 0.00001). The significant correlation between the average SpO2 during the first stage of labor and umbilical vein pH (R = 0.60, p = 0.02) and pO2 (R = 0.54, p = 0.04) was found. No relationship between fetal SpO2 in the first and second stage of labor and Apgar score was observed.


CONCLUSIONS
1. The second stage of labor results in significant decrease in fetal SpO2. 2. The fetal SpO2 > 30% in the first and second stage of labor is related to good neonatal outcome. 3. The fetal SpO2 assessment in first stage of labor seems to be important in newborn's acidosis and hypoxemia predicting.
Leszczyńska-Gorzelak
B
B
Katedry i Kliniki Połoznictwa i Perinatologii Akademii Medycznej w Lublinie.
Poniedziałek-Czajkowska
E
E
Zych
I
I
Grzechnik
M
M
Oleszczuk
J
J
D000138:Acidosis / Q000517:prevention & control; D000328:Adult; D001034:Apgar Score; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D005316:Fetal Distress / Q000097:blood*; D005323:Fetal Monitoring / Q000379:methods; D006801:Humans; D006863:Hydrogen-Ion Concentration; D000860:Hypoxia / Q000517:prevention & control; D007231:Infant, Newborn; D010092:Oximetry / Q000379:methods; D010100:Oxygen / Q000097:blood*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome
D010100:Oxygen