Fetal blood sampling (FBS) has a long history but faces ongoing debates about its relevance. Current evidence shows poor predictive capabilities, and the reliability of fetal blood lactate testing remains disputed. FBS is another example of a fetal monitoring technology that lacks a firm evidence base.
Routine cord blood gas analysis – harmful or helpful?
Fetal heart rate monitoring often shows abnormal patterns that don’t reflect an underlying problem for the fetus. Research on fetal blood sampling has been limited. A recent study found weak correlations between fetal blood pH levels, umbilical cord pH levels and Apgar scores. It is vital that further research takes into account how fetal physiology actually works, rather than repeating inaccurate assumptions.
A Japanese research team compared human and artificial intelligence performance in analyzing CTG data to predict perinatal asphyxia. Clinicians slightly outperformed AI in accurately diagnosing affected babies. However, limitations raise concerns, emphasising the essential role of healthcare professionals over machines in maternity services.
Today’s post reflects on a 1959 trial concerning “fetal distress”. It highlights findings that meconium was a critical indicator of poor outcomes, while abnormal fetal heart rates weren’t reliably predictive. Should we be reevaluating current obsessions with CTG use and focusing on alternative clinical markers?
In a trial comparing fetal blood sampling to digital fetal scalp stimulation for assessing fetal wellbeing, recruitment fell short, concluding early after just 534 participants. Despite showing a significantly lower caesarean section rate with scalp stimulation, the small sample limits the findings. The irony of guidelines undermining evidence development is discussed.
Professor Susan Bewley is a professor of obstetrics with an interest in a great many things. I first became aware of her work many years ago, when I saw her writing about the potential links between the timing of cord clamping, cord blood pH testing, fetal monitoring methods, and perinatal outcomes. Susan recently challenged me to summarise the issues in a blog post – so here we go! Setting the […]
Many things related to fetal monitoring in labour have been introduced because they seemed like a good idea, but never properly evaluated to determine whether they work (like “Fresh Eyes” checks, and central fetal monitoring). There is increasing recognition that one of the reasons for poor outcomes when CTG monitoring is used is not realising the heart rate being recorded is that of the woman and not her fetus. Many […]
When you have been using a test for years and years, you assume someone way back at the beginning did some pretty decent research to determine what numbers are “normal” and a sign of good health, and what numbers are “abnormal” and a sign of poor health. But is that always the case? Why do we test cord blood acid levels? The testing of fetal and neonatal blood acid levels […]
Does #STAN reduce the #caesarean rate when #CTG monitoring is in use? New Australian research!
Birth Small Talk 