Factors influencing fetal pulse oximetry performance.

Fetal pulse oximetry shares many problems with traditional pulse oximetry, but also poses unique challenges that may compromise accurate SpO2 determination and data availability. The purpose of this review is to characterize the factors that may influence fetal pulse oximetry and their relationship to sensor design. A review of the literature of pulse oximetry identifies the factors that have been shown to influence fetal pulse oximetry performance, as well as other factors from traditional pulse oximetry that may also be expected to have an effect. Sensor design choices, including monitoring site, wavelength, and configuration, are related to the incidence and mitigation of these factors. Sensor designs may be characterized by monitoring site, means of retention, and operating mode (reflectance versus transmission). The factors influencing fetal pulse oximetry may be categorized as follows: fetal physiology, tissue characteristics at the monitoring site, sensor-tissue interface, and external influences. Monitoring site selection is of paramount importance in reducing the impact of interfering factors on fetal pulse oximetry performance. Many factors of importance in traditional pulse oximetry have yet to be characterized as far as their potential for interference in fetal pulse oximetry.