Why the study?
Does continuous intrapartum transcutaneous carbon dioxide measurement identify fetal distress in fetuses with arrhythmias during labor?
Does continuous intrapartum transcutaneous carbon dioxide measurement identify fetal distress in fetuses with arrhythmias during labor?
Transcutaneous carbon dioxide monitoring is a viable alternative for fetal surveillance during labor in cases of fetal arrhythmia where standard heart rate monitoring is uninterpretable.
tcpCO2 correctly identified the sole acidosis case with vigorous newborns; hypothesis-generating for arrhythmia surveillance and needs prospective validation.
In nine cases of fetal arrhythmias without cardiac anomalies or congestive heart failure a vaginal delivery was attempted. Due to these arrhythmias adequate fetal heart rate monitoring during labor was not possible. All cases were continuously monitored during labor with the transcutaneous measurement of fetal carbon dioxide tension (tcpCO2). Seven patients could be delivered spontaneously. In one of these cases the newborn was acidotic at birth (pH less than 7.20 in the umbilical artery) which was correctly identified (tcpCO2 greater than 60 mmHg). All newborns were vigorous (Apgar score after 1 minute greater than 7). In cases with uninterpretable fetal heart rate patterns tcpCO2 monitoring of the fetus during labor is an alternative method of fetal surveillance, which identifies fetal distress and can prevent unnecessary operative deliveries.
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Berg et al. (1991) studied this question.
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