Predictive value of pulse oximetry for the development of fetal acidosis

Abstract

To determine the predictive value of fetal pulse oximetry (FPO) for the development of fetal acidosis in cases of non-reassuring fetal heart rate (FHR). In a prospective observational study, pulse oximetry monitoring was examined in cases of non-reassuring FHR during singleton cephalic delivery at 36-42 weeks' gestation. The study examined whether fetal arterial oxygen saturation (FSpO(2)) values <30% for at least 10 min during the last 60 min before delivery increase the risk of fetal acidosis. The predictive reliability of this algorithm and the correlation to fetal acidosis [umbilical artery pH (UApH) <7.15] were analyzed. We included 101 patients with non-reassuring FHR during delivery. The incidence of fetal acidosis was significantly higher when FSpO(2) values <30% were recorded for at least 10 min (P=0.0). An UApH <7.15 was reliably excluded with a negative predictive value of 98.7% and detected with a sensitivity of 92.9%. A low pulse oximetry oxygen saturation <30% for at least 10 min correlates highly with fetal acidosis in cases of non-reassuring FHR. FPO reliably excludes moderate to advanced acidosis and can reduce the frequency of fetal blood analysis (FBA) in cases of non-reassuring cardiotocography (CTG).