General Obstetrics and Gynecology: Obstetrics

Objective: We tested if fetal pulse oximetry in addition to electronic fetal monitoring (CTG) and scalp blood sampling improves the accuracy of fetal assessment and allows safe reduction of operative deliveries ( 50%) and scalp blood sampling ( 50%) performed because of nonreassuring fetal status. Study design: A randomized controlled trial was conducted in 146 patients with term pregnancies in active labor and abnormal fetal heart rate patterns: 73 had electronic fetal heart rate monitoring (CTG) and fetal scalp blood sampling (control group), 73 had CTG, fetal scalp blood sampling, and continuous fetal pulse oximetry (study group). Results: There was a reduction of 50% in operative deliveries and fetal scalp blood sampling performed because of nonreassuring fetal status in the study group: operative deliveries, study versus control 25/49 (P% .001); fetal scalp sampling, study versus control 32/64 (P% .001). An increase in cesarean sections because of dystocia in the study group did not change the net number of operative deliveries. There was no difference between the 2 groups in adverse maternal or neonatal outcomes, as well as for the end points of metabolic acidosis and need for resuscitation. Conclusion: There was a safe reduction in operative deliveries ( 50%) and scalp blood sampling ( 50%) performed because of nonreassuring fetal status. The increase in cesarean sections because of dystocia in the study group was a well-documented arrest of labor, but it did not change the total number of operative deliveries in this group. 2004 Elsevier Inc. All rights reserved.