Outcomes Compared for Different Fetal Surveillance Methods
By Elana Gotkine HealthDay Reporter
MONDAY, Feb. 5, 2024 -- The rate of neonatal encephalopathy and severe neonatal acidemia is increased with use of external ultrasound transducer monitoring of fetal heart rate without simultaneous maternal heart rate recording, according to a study published online Jan. 22 in the American Journal of Gynecology.
Mikko Tarvonen, Ph.D., from the University of Helsinki, and colleagues compared different fetal surveillance methods and their association with adverse short- and long-term fetal and neonatal outcomes in a retrospective cohort of deliveries. The cohort was divided into three groups: women with ultrasound transducer, women with both ultrasound transducer and maternal heart rate transducer, and women with internal fetal scalp electrode (38.1, 29.1, and 32.7 percent of cases, respectively, among the 213,798 deliveries).
The researchers found that in fetuses of women with ultrasound transducer alone, neonatal encephalopathy and severe acidemia were significantly higher compared with concurrent external fetal and maternal heart rate recording (odds ratios, 1.48 and 2.03, respectively). An increased risk for neonatal intubation for resuscitation was also seen in association with monitoring with ultrasound transducer alone (odds ratio, 1.22). In the ultrasound transducer and concurrent ultrasound transducer and maternal heart rate recording groups, the risk for severe neonatal acidemia was increased compared with those monitored with fetal scalp electrode (odds ratios, 2.78 and 1.37, respectively). No difference in the risk for neonatal encephalopathy was seen for newborns between the groups.
"Based on our results, this tragedy can be effectively prevented by combining maternal pulse recording with fetal heart rate monitoring," Tarvonen said in a statement. "This method allows professionals to be sure of whose heart rate they are monitoring."
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Posted February 2024
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