Fetal pulse oximetry and cesarean delivery.
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].).
Bloom
Steven L
SL
University of Texas Southwestern Medical Center, Dallas, TX 75390, USA. steven.bloom@utsouthwestern.edu
Spong
Catherine Y
CY
Thom
Elizabeth
E
Varner
Michael W
MW
Rouse
Dwight J
DJ
Weininger
Sandy
S
Ramin
Susan M
SM
Caritis
Steve N
SN
Peaceman
Alan
A
Sorokin
Yoram
Y
Sciscione
Anthony
A
Carpenter
Marshall
M
Mercer
Brian
B
Thorp
John
J
Malone
Fergal
F
Harper
Margaret
M
Iams
Jay
J
Anderson
Garland
G
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