Reliability of fetal blood sampling

Bowe, E T; Beard, R. W.; Finster, Mieczyslaw; Poppers, Paul J.; Adamsons, Karlis; James, L. Stanley

doi:10.1016/0002-9378(70)90598-3

Cited by 63 publications

(25 citation statements)

References 8 publications

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“…Studies in fetal monkeys showed a good correlation of acid-base parameters between scalp and carotid blood [6], and human data have shown similar correlations between pH and lactate values obtained in scalp blood and those recorded shortly after birth in the umbilical artery and vein [7][8][9][10][11]. However, correlation of these values with newborn outcome depends on the time interval between scalp sampling and birth [12].…”

Section: Fetal Blood Sampling For Ph and Lactate Measurementsmentioning

confidence: 99%

FIGO consensus guidelines on intrapartum fetal monitoring: Adjunctive technologies

Visser

Ayres-de-Campos

2015

Intl J Gynecology & Obste

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Section: Fetal Blood Sampling For Ph and Lactate Measurementsmentioning

confidence: 99%

FIGO consensus guidelines on intrapartum fetal monitoring: Adjunctive technologies

Visser

Ayres-de-Campos

2015

Intl J Gynecology & Obste

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“…Fetal pH values obtained shortly before delivery normally compare well with those o£ blood from the umbilical artery, and with the clinical condition of the infant at birth [6]. In some cases, however, the fetal pH during labor does not agree with the clinical condition at birth.…”

mentioning

confidence: 70%

“…of cases 'Falsely abnormal' (%) BEARD R. W. et al [5] KUBLI F. [21] BOWE E. T. et al [6] Present series* 11.2 * Cases at risk tion at birth, and abnormal because the fetal acidbase state during läbor was found to be abnormal [20] -is nearly identical in. all reported series [5,6,21]; in our own series they comprised 11.2% [29] of the cases at risk (Tab. I).…”

Section: Authormentioning

confidence: 99%

“…monitoring of the fetus-at-risk during labor, i. e. The main problem in this regard is one of false fetal heart rate (FHR) monitoring and fetal blood positives or falsely abnormal results, i. e., the cases sampling (FBS), has resulted in the accumulation (by no means rare) in which a low fetal pH during of considerable clinical experience in this area labor does not reflect a state of fetal hypoxia [2,6, within a short period of time. 20,27,31].…”

mentioning

confidence: 99%

“…In some cases, however, the fetal pH during labor does not agree with the clinical condition at birth. A low pH (< 7.20) in these instances leads one to expect the delivery of a distressed infant, whereas the APGAR score proves to be ^ 7 [2,6,20,27,31]. The overall incidence of such "falsely abnormal" cases -false because the infant is in good condiTab.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Recognition and significance of maternogenic fetal acidosis during intensive monitoring of labor

Roversi¹,

Canussio²,

Spennacchio³

1975

Journal of Perinatal Medicine

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Response of Fetal Acid—Base Balance to duration of Second Stage of Labour

Roemer

Harms

Buess

et al. 1976

Intl J Gynecology & Obste

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Data from 4081 vaginal deliveries (no caesarean sections) were analyzed retrospectively (IBM 730/158) with regard to duration of second and "final stage" of labour and fetal outcome (acid-base balance and apgar scores). The average duration of the two periods amounted to 22.8+/-29.6 and 9.9+/-7.8 min. Mean pH (UA) was 7.268+/-0.084 and the acidotic risk (pH less than 7.20, pH less than 7.10) 13.4 and 1.6% respectively. The distribution of the Apgar-scores after 1 min was assessed: 0-3: 1.7%, 4-6: 5.4%, 7-10: 92.9%. The dependance of the time variables from parity was studied. Two samples (N1=1755, N2=1098) of uncomplicated term pregnancies were chosen according to 7 clinical selection criteria differing only in the presence of cord entanglements at birth. The association between the two time variables and parameters of the fetal acid-base balance in cord blood was evaluated using rank correlation- and polynomial regression analysis. Highly significant correlations (tau) were found between the variable time and actual pH in blood of the umbilical artery and vein as well as pCO2, BEECF and HbO2 in the umbilical vein. The association however is not very close and thus clinically not of great importance. The deltapH (UA & UV) pro 60 min of second (and "final") stage of labour was computed and amounted to -0.024 (-0.087) in blood of the umbilical artery and -0.036 (-0.115) in blood of the umbilical vein and -0.017 (-0.062) (UA) and -0.032 (-0.120) units (UV) in the sample with and without apparent cord entanglements at birth respectively. The response of fetal acid-base balance to cord compression during second stage of labour was assesses: The acidotic risk (pH less 7.2) was doubled: 14.5% (7.7%) and AV-differences of all variables were "opened" if cordcoilings were observed. Apgar scores were not significantly different. Moreover, the association between AV-differences of each parameter and the variable time was studied: it became evident that with passage of time AV-difference is "closed" (-0.052 AV DpH/60 min "final stage" of labour, N=1098) indicating time related impairment of placental function. From these observations and data of the literature the conclusion is drawn that second stage of labour should not exceed 45 min in any patient. Furthermore it is concluded that in cases without signs of impending fetal distress it seems to be possible to wait more than 20 (Multipara) or 30 min (Primipara) duration of "final stage" without increased risk of fetal peril measured in terms of acidemia and clinical depression. This is valid only in term pregnancies with the possibility of continuous monitoring of FHR, in cases with normal uterine activity, uneventful course of first stage of labour and cooperative, vigorous patients. The indications for termination of delivery by vaginal operations in cases without impending fetal distress are discussed.

show abstract

Reliability of fetal blood sampling

Cited by 63 publications

References 8 publications

FIGO consensus guidelines on intrapartum fetal monitoring: Adjunctive technologies

FIGO consensus guidelines on intrapartum fetal monitoring: Adjunctive technologies

Recognition and significance of maternogenic fetal acidosis during intensive monitoring of labor

Response of Fetal Acid—Base Balance to duration of Second Stage of Labour

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