Optimiert die Fetalblutanalyse die Qualität der geburtshilflichen Versorgung?

Abstract

Introduction: The additional use of fetal blood sampling has been suggested in cases with continuous cardiotocography to improve fetal surveillance during labor. It was the aim of this study to critically evaluate the potential benefit with the possibility of reducing the number of cesarean sections and improving the outcome of the newborn. Method: Data were prospectively collected during the Hesse perinatal survey from 1990-2000 in >98% of all births in the state. All cases with risks in addition to indications of fetal distress in the cardiotocography tracing were excluded by means of a multivariate analysis. 15468 singleton births at >37 weeks in a vertical position were included. In this sample a statistical evaluation ofcesarean section rate, clinical status of the newborn at birth and necessity of transfering a newborn to the NICU was performed. Results: The number of secondary cesarean sections due to indications of fetal distress was significantly reduced from 14.9 to 8.9% (p < 0.01) when fetal blood sampling was utilized. Furthermore early morbidity (Apgar 5min, 10 min <7) was reduced (p < 0.01). The numbers of newborns which had to be transfered to the neonatal intensive care unit were significantly reduced. Conclusion: The additional use of fetal blood sampling during fetal surveillance is beneficial for mother and child.