Methodology and clinical value of transcutaneous blood gas measurements in the fetus
Abstract
Aiming at an improvement of fetal surveillance in high risk cases, a clinical trial was performed to evaluate the potential of fetal tcPco2 monitoring. An electrochemical tcPco2 sensor heated at 44 degrees C was applied in 119 fetuses after abnormal heart rate patterns had occurred. The number of operative deliveries for fetal distress was reduced to 14 cases by means of the biochemical parameters (tcPco2) and fetal blood analysis (FBA). In the majority of cases with pathologic heart rate patterns the tcPco2 values were prepathologic or normal (60%), while in 68% of cases with prepathologic heart rate patterns the tcPco2 level was normal. At all instances an intrauterine complication was indicated by a marked rise of the tcPco2 level. The clinical benefit of using the tcPco2 measurement is the better specificity of detecting fetal distress when compared with the use of cardiotocography alone. Furthermore the tcPco2 technique has the advantage of providing continuous information about one biochemical parameter and of avoiding the necessity of repeated incisions of the scalp, as compared with the technique of fetal blood analysis. In conclusion the use of this non-traumatic technique lends itself to avoid unnecessary operative deliveries in high risk cases.
How strong is the evidence?
Evidence Hub reads this as a clinical trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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