E Mozurkewich1, F M Wolf. 1. Department of Obstetrics and Gynecology, University of Michigan, F4835, Box 0264 Mott Hospital, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-0264, USA. mozurk@umich.edu
Abstract
BACKGROUND: Over the past four decades, continuous electronic fetal monitoring (EFM) has been increasingly employed to detect fetal acidemia in labor, with a view toward prevention of hypoxic ischemic encephalopathy, permanent neurologic injury, and death. Although very sensitive, this technology has low specificity, and a high false positive rate. This false positive rate has resulted in operative intervention on behalf of many fetuses who were not in fact in danger of neurologic injury or death. Near-infrared spectroscopy has been developed to directly measure fetal cerebral oxygenation, with a view toward identification of those fetuses truly at risk. OBJECTIVES: To determine the effects of the use of near-infrared spectroscopy (NIRS) to assess fetal condition during labour, on maternal and perinatal outcomes. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register. Date of last search: November 1999. SELECTION CRITERIA: Randomized trials comparing near-infrared spectroscopy with continuous EFM alone or continuous EFM and scalp pH. DATA COLLECTION AND ANALYSIS: Eligibility and trial quality were assessed by one reviewer. MAIN RESULTS: No randomized trials were identified. Thus no studies were included. REVIEWER'S CONCLUSIONS: There is currently insufficient evidence to assess the efficacy of fetal surveillance by near-infrared spectroscopy.
BACKGROUND: Over the past four decades, continuous electronic fetal monitoring (EFM) has been increasingly employed to detect fetal acidemia in labor, with a view toward prevention of hypoxic ischemicencephalopathy, permanent neurologic injury, and death. Although very sensitive, this technology has low specificity, and a high false positive rate. This false positive rate has resulted in operative intervention on behalf of many fetuses who were not in fact in danger of neurologic injury or death. Near-infrared spectroscopy has been developed to directly measure fetal cerebral oxygenation, with a view toward identification of those fetuses truly at risk. OBJECTIVES: To determine the effects of the use of near-infrared spectroscopy (NIRS) to assess fetal condition during labour, on maternal and perinatal outcomes. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register. Date of last search: November 1999. SELECTION CRITERIA: Randomized trials comparing near-infrared spectroscopy with continuous EFM alone or continuous EFM and scalp pH. DATA COLLECTION AND ANALYSIS: Eligibility and trial quality were assessed by one reviewer. MAIN RESULTS: No randomized trials were identified. Thus no studies were included. REVIEWER'S CONCLUSIONS: There is currently insufficient evidence to assess the efficacy of fetal surveillance by near-infrared spectroscopy.