NICHD finding: the nail in the coffin for fetal pulse oximetry?

Is fetal pulse oximetry a waste of time? Riveting results from an important trial presented at the 26th annual SMFM meeting in Miami in February suggest just that-and seemingly shatter the whole premise behind fetal pulse oximetry: that it might either improve perinatal outcome or lower cesarean delivery rates.

The practice of using fetal oximetry to measure fetal oxygen saturation during labor was already on pretty shaky ground when National Institute of Child Health and Human Development (NICHD) MFMU Network researchers decided it was time to assess the device's effectiveness in a large, prospective well-designed trial. After all, in the wake of the FDA's conditional approval of the oximetry device in May 2000, the dystocia rate had unexpectedly and inexplicably doubled, pointed out Bethesda investigator, S. L. Bloom. Moreover, in a subsequent ACOG Committee Opinion, the organization had refused to endorse the new technology.

Aiming to assess the technology in "a real-world setting," the researchers set out to measure whether a clinician's awareness of fetal oxygen saturation values used in conjunction with continuous electronic fetal monitoring is associated with the condition of the newborn or linked to a significant change in the overall cesarean delivery rate (that includes C/S performed specifically for dystocia and nonreassuring fetal heart rate).

Bloom SL for the NICHD MFMU Network, Bethesda, Maryland. The MFMU Network randomized trial of fetal pulse oximetry. Am J Obstet Gynecol. 2005;193(6 suppl):S2. (Abstract 1)