title: Fetal pulse oximetry and cesarean delivery.
abstract: BACKGROUND
  Knowledge of fetal oxygen saturation, as an adjunct to electronic fetal monitoring, may be associated with a significant change in the rate of cesarean deliveries or the infant's condition at birth.
  
  
  METHODS
  We randomly assigned 5341 nulliparous women who were at term and in early labor to either "open" or "masked" fetal pulse oximetry. In the open group, fetal oxygen saturation values were displayed to the clinician. In the masked group, the fetal oxygen sensor was inserted and the values were recorded by computer, but the data were hidden. Labor complicated by a nonreassuring fetal heart rate before randomization was documented for subsequent analysis.
  
  
  RESULTS
  There was no significant difference in the overall rates of cesarean delivery between the open and masked groups (26.3% and 27.5%, respectively; P=0.31). The rates of cesarean delivery associated with the separate indications of a nonreassuring fetal heart rate (7.1% and 7.9%, respectively; P=0.30) and dystocia (18.6% and 19.2%, respectively; P=0.59) were similar between the two groups. Similar findings were observed in the subgroup of 2168 women in whom a nonreassuring fetal heart rate was detected before randomization. The condition of the infants at birth did not differ significantly between the two groups.
  
  
  CONCLUSIONS
  Knowledge of the fetal oxygen saturation is not associated with a reduction in the rate of cesarean delivery or with improvement in the condition of the newborn. (ClinicalTrials.gov number, NCT00098709 [ClinicalTrials.gov].).
authors.affiliation: University of Texas Southwestern Medical Center, Dallas, TX 75390, USA. steven.bloom@utsouthwestern.edu
authors.forename: Steven L
authors.initials: SL
authors.lastname: Bloom
authors.forename: Catherine Y
authors.initials: CY
authors.lastname: Spong
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Thom
authors.forename: Michael W
authors.initials: MW
authors.lastname: Varner
authors.forename: Dwight J
authors.initials: DJ
authors.lastname: Rouse
authors.forename: Sandy
authors.initials: S
authors.lastname: Weininger
authors.forename: Susan M
authors.initials: SM
authors.lastname: Ramin
authors.forename: Steve N
authors.initials: SN
authors.lastname: Caritis
authors.forename: Alan
authors.initials: A
authors.lastname: Peaceman
authors.forename: Yoram
authors.initials: Y
authors.lastname: Sorokin
authors.forename: Anthony
authors.initials: A
authors.lastname: Sciscione
authors.forename: Marshall
authors.initials: M
authors.lastname: Carpenter
authors.forename: Brian
authors.initials: B
authors.lastname: Mercer
authors.forename: John
authors.initials: J
authors.lastname: Thorp
authors.forename: Fergal
authors.initials: F
authors.lastname: Malone
authors.forename: Margaret
authors.initials: M
authors.lastname: Harper
authors.forename: Jay
authors.initials: J
authors.lastname: Iams
authors.forename: Garland
authors.initials: G
authors.lastname: Anderson
mesh_terms: D000328:Adult; D001237:Asphyxia / Q000175:diagnosis; D002585:Cesarean Section / Q000706:statistics & numerical data*; D036861:Delivery, Obstetric; D004420:Dystocia; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis; D005323:Fetal Monitoring; D006340:Heart Rate, Fetal; D006801:Humans; D007231:Infant, Newborn; D010092:Oximetry / Q000009:adverse effects; D011247:Pregnancy; D011256:Pregnancy Outcome