title: Intrapartum surveillance of IUGR fetuses with cardiotocography and fetal pulse oximetry.
abstract: OBJECTIVE
  To investigate the efficacy and safety of intrapartum fetal pulse oximetry, as a predictor of metabolic acidosis at birth of fetuses with intrauterine growth retardation (IUGR).
  
  
  METHODS
  We studied 18 IUGR fetuses (group I) and a control group of 30 appropriate for gestational age (AGA) fetuses (group II) during labor. Both groups had abnormal fetal heart rate tracings and were monitored simultaneously throughout labor with cardiotocography and fetal pulse oximetry. Apgar scores, pH and base excess of fetal blood obtained from the umbilical artery after delivery were compared in both groups.
  
  
  METHODS
  The Fetal Surveillance Unit of the 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, Athens University.
  
  
  RESULTS
  In IUGR fetuses, when their oxygen saturation value (FSPO2) was less than 34%, cord artery pH was 7.10 +/- 0.04, base excess -13 +/- -1 mmol/l and Apgar scores < or =5 at the 5th min, and when FSPO2 was over 35%, artery pH was 7.29 +/- 0.08, base excess -8 +/- -2 mmol/l and Apgar scores > or =7 at the 5th minute. In cases of drops of FSPO2)below 30% for more than 2 min, labor was completed operatively and cord pH was 7.00 +/- 0.04, base excess -15 +/- -2 mmol/l and Apgar scores < or =5 at the 5th minute. In AGA fetuses, when FSPO2 was over 30%, artery pH was over 7.20, base excess <-11 mmol/l and Apgar scores > or =9 at the 5th minute; in contrast, when FSPO2 was <30% for 2 min, a cesarean section was performed and cord pH was < or =7.02, base excess > or =-13 mmol/l and Apgar scores < or =4 at the 5th minute.
  
  
  CONCLUSIONS
  In IUGR fetuses, FSPO2 values less than 34% represent an acidotic status, while values of > or =35% are well tolerated. Fetal pulse oximetry proved reliable, according to umbilical cord blood measurements and Apgar scores, reducing cesarean deliveries in cases of nonreassuring cardiotocographic patterns in IUGR fetuses.
authors.affiliation: Second Department of Obstetrics and Gynecology, 'Aretaieion' Hospital, Medical School, Athens University, Athens, Greece. arrysiri@hotmail.com
authors.forename: Charalambos
authors.initials: C
authors.lastname: Siristatidis
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Salamalekis
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Vitoratos
authors.forename: Constantinos
authors.initials: C
authors.lastname: Loghis
authors.forename: John
authors.initials: J
authors.lastname: Salloum
authors.forename: Demetrios
authors.initials: D
authors.lastname: Kassanos
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Panayotopoulos
authors.forename: George
authors.initials: G
authors.lastname: Creatsas
mesh_terms: D000138:Acidosis / Q000150:complications; D000328:Adult; D015148:Cardiotocography; D016022:Case-Control Studies; D005260:Female; D005312:Fetal Blood; D005317:Fetal Growth Retardation / Q000097:blood / Q000150:complications / Q000196:embryology* / Q000503:physiopathology*; D006340:Heart Rate, Fetal; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases; D007743:Labor, Obstetric; D010092:Oximetry; D010100:Oxygen / Q000097:blood; D011159:Population Surveillance; D011247:Pregnancy; D011379:Prognosis
chemical_list: D010100:Oxygen