title: Severe variable decelerations and fetal pulse oximetry during the second stage of labor.
abstract: OBJECTIVE
  The aim of the study was to investigate the usefulness of fetal pulse oximetry in cases of severe variable decelerations in the second stage of labor.
  
  
  METHODS
  It is a prospective study including 58 patients. Thirty-eight patients (group A) had a normal uncomplicated labor and 20 patients (group B) developed severe variable decelerations during the second stage of labor. All patients were primiparous with normal pregnancies and had electronic fetal monitoring of labor in conjunction with fetal pulse oximetry. An estimation of fetal pH and base deficit was performed at delivery in all patients.
  
  
  RESULTS
  There was no statistically significant difference in relation to maternal age and gestational age between the two groups. Group A patients did not delivered neonates with metabolic acidosis. Six out of 20 (group B) patients delivered neonates with a pH <7.10 despite a fetal pulse oximetry reading of >30%.
  
  
  CONCLUSIONS
  It appears that fetal pulse oximetry is not capable of detecting pre-acidotic or acidotic fetuses during the second stage of labor in patients with severe variable decelerations and the management of such patients should be supported by fetal scalp pH when indicated or otherwise the obstetrician should expedite delivery either with assisted operative delivery or cesarean section. Fetal heart rate monitoring was introduced into clinical practice over 30 years ago. It continues to be the predominant method of intrapartum fetal surveillance despite worries about its accuracy and efficacy.
authors.affiliation: Second Department of Obstetrics and Gynecology, Aretaieio Hospital, Athens, Greece. eurotas@ath.forthnet.gr
authors.forename: Emanouel
authors.initials: E
authors.lastname: Salamalekis
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Bakas
authors.forename: Ioannis
authors.initials: I
authors.lastname: Saloum
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Vitoratos
authors.forename: Georgios
authors.initials: G
authors.lastname: Creatsas
mesh_terms: D000138:Acidosis / Q000175:diagnosis* / Q000196:embryology*; D000328:Adult; D005260:Female; D005312:Fetal Blood; D005323:Fetal Monitoring; D006340:Heart Rate, Fetal; D006801:Humans; D006859:Hydrogen / Q000097:blood; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D007748:Labor Stage, Second; D010092:Oximetry / Q000592:standards*; D011247:Pregnancy; D011446:Prospective Studies
chemical_list: D006859:Hydrogen