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 val...

Electronic fetal monitoring (EFM) involves the use of cardiotocograph (CTG) to asses fetal wellbeing during labour in order to detect intrapartum fetal hypoxia early so as to institute timely and appropriate action. Indeed, when CTG was introduced into obstetric practice in the 1960s, it was expected to prevent perinatal brain injury and reduce the incidence of short term (neonatal admissions, ...

on scalp blood, such as measurement of lactate concentration, do not appear to improve diagnostic accuracy. Results of direct intrapartum monitoring of the neurological state of the fetus by electroencephalogram recordings'8 19 are difficult to interpret and once again probably identify only severe fetal distress. Against a background of slow technical progress there has been an increasing dema...

In the linked randomised controlled trial, Wiberg-Itzel and colleagues compare the effectiveness of two methods of diagnosing hypoxia in the fetus during labour— scalp pH analysis and scalp lactate analysis.1 Fetal wellbeing during labour depends on several factors—an adequate supply of oxygenated maternal blood reaching the placental intervillous space, gas exchange across an undamaged placent...

BACKGROUND Cardiotocography has a poor diagnostic value in detecting fetal acidosis. Spectral analysis of fetal heart rate variability can be used to monitor the fetal autonomic nervous system. OBJECTIVE To determine the value of spectral analysis for fetal surveillance. METHODS A systematic search was performed in the electronic databases CENTRAL (the Cochrane Library; 2007, Issue 3), PUBM...

In 1985, the World Health Organization (WHO) stated that no country should have an induction rate higher than 10%. Inappropriate use of technology in childbirth has become an issue of international concern with reports of its negative impact on maternal and infant physical and psychological wellbeing. The aim of this paper is to describe the outcome data from a prospective cohort study and how ...

Key content Fetal anaemia can be caused by alloimmune or infectious red cell destruction, disorders of fetal production, haemorrhage and as a complication monochorionic multifetal pregnancy. A fetus at risk from maternal alloimmunisation detected serum screening for antibodies ultrasonography. Undiagnosed cases may present in routine obstetric practice, so awareness the identification initial m...