A new study shows that a fetal electrocardiogram (FE) helps reduce cesarean incidence rate in women in labor at risk of losing fetal wellbeing, and also presents more advantages than pulse oximetry.

Researchers at the University of Granada conducted a study involving 180 women in labor who were admitted to the dilation area of the University Hospital Virgen de las Nieves (Granada, Spain). The women were monitored with FE and with cardiotocographic recordings (CTG), which have been found to be compatible with the evaluation of risk of loss of fetal wellbeing.

The results showed that women who were monitored with FE had a lower cesarean delivery rate (30%) compared to CTG monitoring (46.7%), obtained better fetal Apgar test results, and also achieved better values in fetal umbilical cord gas analysis at birth than those recorded with pulse oximetry. The researchers also observed that FE providing more continuous information and a better signal, thus helping the obstetrician to control the state of the fetus via more accurate real-time monitoring. The results of the study were published in the June 2011 issue of the Spanish language journal Progresos en Ginecología y Obstetricia.

"Some people believe that both methods are equally effective and that they can be used in the same cases," said lead author Mercedes Valverde Pareja, a researcher at the department of gynecology and obstetrics at the University of Granada. "With this work, we found that their effectiveness is not the same, as they operate at different levels of fetal physiology and therefore give some very precise data. Furthermore, if compared, fetal electrocardiogram detects acidosis at an earlier stage, thus allowing them to have healthy fetuses."

Metabolic acidosis is defined as a low pH (lower than 7.35) due to an excess of acid or a deficit of base. Metabolic acidosis is a common finding in the sick newborn, generally due to stress during delivery; in some cases, the metabolic acidosis is acute, severe, and life threatening, as in shock. In other cases, the acidosis is mild, but persistent and, in still others, may be intermittent. The most common approach to metabolic acidosis in neonates is to correct the acidosis by administering bicarbonate.

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