[Foetal scalp blood sampling: impact on the incidence of Caesarean section and assisted vaginal deliveries for non-reassuring foetal heart rate and its use according to gestational age].
BACKGROUND
Interpretation of a suspicious, non-reassuring or pathological foetal heart rate tracing does not provide any direct information about foetal oxygen saturation, blood gas status or the extent of changes in pH. Without foetal scalp blood sampling, such tracings often necessitate rapid intervention to deliver the baby by Caesarean section or assisted vaginal delivery. The aim of this study was to show the impact of foetal blood sampling on reducing the number of Caesarean sections and assisted vaginal deliveries in a clinical setting in such cases.


METHODS
A retrospective study of the mode of delivery in 669 women where foetal scalp blood sampling had been performed for suspicious or pathological foetal heart rate monitoring, in the period 2008-2009 was undertaken. The gestational age of the foetus was also investigated.


RESULTS
Because one or more results of foetal scalp pH were within the normal range an operative delivery could be avoided in 6.4% of the study population, in spite of the non-reassuring foetal heart rate monitoring. Foetal blood sampling was performed more frequently in post-term pregnancies.


CONCLUSIONS
Foetal blood analysis still is an effective tool to reduce unnecessary operative deliveries and should be regularly included in intrapartum monitoring. The risk of foetal complications is low compared with the reduction in the rate of Caesarean sections and assisted vaginal deliveries. Obstetricians are evidently becoming more willing to carry out foetal scalp blood sampling with rising gestational age.
Universitätsklinik für Frauenheilkunde und Geburtshilfe, Medizinische Universität Graz, Graz, Österreich. philipp.reif@klinikum-graz.at
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P
Reif
J
J
Haas
W
W
Schöll
U
U
Lang
D000137:Acid-Base Imbalance / Q000097:blood / Q000175:diagnosis / Q000628:therapy; D001034:Apgar Score; D001317:Austria; D001800:Blood Specimen Collection / Q000706:statistics & numerical data*; D015148:Cardiotocography; D002585:Cesarean Section / Q000706:statistics & numerical data*; D005113:Extraction, Obstetrical / Q000706:statistics & numerical data*; D005260:Female; D005316:Fetal Distress / Q000097:blood / Q000175:diagnosis* / Q000628:therapy*; D005865:Gestational Age; D006340:Heart Rate, Fetal; D006785:Hospitals, University; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced / Q000706:statistics & numerical data; D010100:Oxygen / Q000097:blood; D011247:Pregnancy; D011273:Pregnancy, Prolonged / Q000097:blood; D012189:Retrospective Studies; D012307:Risk Factors; D012535:Scalp / Q000098:blood supply*; D014600:Utilization Review / Q000706:statistics & numerical data
D010100:Oxygen