Key result
Combined biophysical intrapartum fetal monitoring with CTG and fetal pulse oximetry significantly reduced the rate of Caesarean deliveries for fetal hypoxia compared to CTG alone (13.9% vs 20.7%, P=0.022), but did not significantly decrease the overall operative delivery rate.
Why the study?
Does combined biophysical fetal monitoring with CTG plus fetal pulse oximetry reduce the rate of operative deliveries in women in active labour with non-reassuring CTG patterns?
RCT (n=648)
Permuted-blocks model (size of 8)
No
Does combined biophysical fetal monitoring with CTG plus fetal pulse oximetry reduce the rate of operative deliveries in women in active labour with non-reassuring CTG patterns?
Combined biophysical intrapartum fetal monitoring with CTG and fetal pulse oximetry safely reduces the Caesarean rate for non-reassuring CTG patterns, but does not decrease the overall operative delivery rate.
Reduces Caesareans for fetal hypoxia but not overall operative deliveries; extends RCT evidence for adjunct monitoring without broad impact on delivery mode.
Objective. The aim of the study was to test the performance and safety of fetal pulse oximetry (FPO) in the management of non-reassuring CTG patterns in labour. Materials. A randomized controlled trial was conducted in 648 women in active labour and pregnancies > 36 weeks with reassuring admission CTG followed by non-reassuring patterns. All women were divided into 2 groups according to the mode of fetal intrapartum monitoring used. In the study group (n=324), women received a combined biophysical fetal monitoring with CTG plus FPO (n=324), while the control group of women had CTG alone monitoring. Main outcome measures were rates of operative deliveries and neonatal outcome. Results. The analysis showed a significant reduction of Caesarean deliveries in the study group receiving a combined fetal monitoring compared to controls (45/324 vs. 67/324; P=0.022). The total operative delivery rate was also lower, but not significantly (92/324 vs. 104/324, P=0.302). No comparative differences were observed in neonatal outcomes, except for 2 controls-group neonates born with pH-UA < 7.1, however completely normal further postnatal course. No such case was encountered in the study group neonates, and no perinatal deaths occurred during the study. Conclusions. A combined biophysical intrapartum fetal monitoring with CTG and fetal pulse oximetry enables safe reduction in Caesarean rate for non-reassuring CTG patterns, however it could not decrease a total operative delivery rate. Condensation: Fetal pulse oximetry safely reduces a Caesarean rate for non-reassuring patterns, but not the overall Caesarean rate.
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Matasová et al. (2013) conducted an RCT in Non-reassuring CTG patterns in active labour (n=648). Combined biophysical fetal monitoring with CTG plus fetal pulse oximetry (FPO) vs. CTG alone monitoring was evaluated on Caesarean deliveries for fetal hypoxia (p=0.022). Combined biophysical intrapartum fetal monitoring with CTG and fetal pulse oximetry significantly reduced the rate of Caesarean deliveries for fetal hypoxia compared to CTG alone (13.9% vs 20.7%, P=0.022), but did not significantly decrease the overall operative delivery rate.
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