Expert review--identification of intra-partum fetal compromise.
Whilst most cases of cerebral palsy occur as a consequence of an ante-natal insult, a significant proportion, particularly in the term fetus, are attributable to intra-partum hypoxia. Intra-partum monitoring using continuous fetal heart rate assessment has led to an increased incidence of operative delivery without a concurrent reduction in the incidence of cerebral palsy. Despite this, birth asphyxia remains the strongest and most consistent risk factor for cerebral palsy in term infants. This review evaluates current intra-partum monitoring techniques as well as alternative approaches aimed at better identification of the fetus at risk of compromise in labour.
Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, Du Cane Road, London W12 0HS, UK; Institute for Reproductive and Developmental Biology, Imperial College London, London W12 0HS, UK.
Tomas
T
Prior
Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, Du Cane Road, London W12 0HS, UK; Institute for Reproductive and Developmental Biology, Imperial College London, London W12 0HS, UK; Mater Research Institute/University of Queensland, Aubigny Place, Raymond Terrace, South Brisbane, QLD 4101, Australia. Electronic address: skumar@mmri.mater.org.au.
Sailesh
S
Kumar
D015148:Cardiotocography; D004562:Electrocardiography; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D005316:Fetal Distress / Q000097:blood / Q000175:diagnosis*; D005323:Fetal Monitoring / Q000379:methods*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007743:Labor, Obstetric; D019344:Lactic Acid / Q000097:blood; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging; D010092:Oximetry; D011247:Pregnancy; D018608:Ultrasonography, Doppler; D014469:Umbilical Arteries / Q000000981:diagnostic imaging; D014471:Umbilical Veins / Q000000981:diagnostic imaging
D019344:Lactic Acid
Cerebral palsy; Fetal compromise; Fetal distress; Hypoxia; Intrapartum monitoring