Fetal scalp blood sampling during labor: an appraisal of the physiological basis and scientific evidence

Edwin Chandraharan, Nana Wiberg

Research output: Contribution to journalArticlepeer-review

10 Citations (SciVal)

Abstract

Fetal cardiotocography is characterized by low specificity; therefore, in an attempt to ensure fetal well-being, fetal scalp blood sampling has been recommended by most obstetric societies in the case of a non-reassuring cardiotocography. The scientific agreement on the evidence for using fetal scalp blood sampling to decrease the rate of operative delivery for fetal distress is ambiguous. Based on the same studies, a Cochrane review states that fetal scalp blood sampling increases the rate of instrumental delivery while decreasing neonatal acidosis, whereas the National Institute of Health and Clinical Excellence guideline considers that fetal scalp blood sampling decreases instrumental delivery without differences in other outcome variables. The fetal scalp is supplied by vessels outside the skull below the level of the cranial vault, which is likely to be compressed during contractions. The self-regulated redistribution of oxygenated blood from peripheral to central organs causes peripheral ischemia, thus theoretically bringing into question the scalp capillary bed as representative of the central circulation.
Original languageEnglish
Pages (from-to)544-547
JournalActa Obstetricia et Gynecologica Scandinavica
Volume93
Issue number6
DOIs
Publication statusPublished - 2014

Subject classification (UKÄ)

  • Obstetrics, Gynecology and Reproductive Medicine

Keywords

  • Cardiotocography
  • fetal scalp blood sampling
  • lactate
  • pH
  • Cochrane
  • systematic review
  • instrumental delivery
  • fetal surveillance

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