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

Chandraharan, Edwin and Wiberg, Nana LU (2014) In Acta Obstetricia et Gynecologica Scandinavica 93(6). p.544-547
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... (More)
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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cardiotocography, fetal scalp blood sampling, lactate, pH, Cochrane, systematic review, instrumental delivery, fetal surveillance
in
Acta Obstetricia et Gynecologica Scandinavica
volume
93
issue
6
pages
544 - 547
publisher
Wiley-Blackwell
external identifiers
  • wos:000337566200005
  • scopus:84901625699
ISSN
1600-0412
DOI
10.1111/aogs.12416
language
English
LU publication?
yes
id
32a0db7a-0c01-492d-9409-8358b2a64db0 (old id 4609603)
date added to LUP
2014-09-01 07:43:34
date last changed
2017-04-23 03:57:33
@article{32a0db7a-0c01-492d-9409-8358b2a64db0,
  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.},
  author       = {Chandraharan, Edwin and Wiberg, Nana},
  issn         = {1600-0412},
  keyword      = {Cardiotocography,fetal scalp blood sampling,lactate,pH,Cochrane,systematic review,instrumental delivery,fetal surveillance},
  language     = {eng},
  number       = {6},
  pages        = {544--547},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Obstetricia et Gynecologica Scandinavica},
  title        = {Fetal scalp blood sampling during labor: an appraisal of the physiological basis and scientific evidence},
  url          = {http://dx.doi.org/10.1111/aogs.12416},
  volume       = {93},
  year         = {2014},
}