FPO studied in broader range of deliveries.(Obstetrics)

WASHINGTON -- The use of fetal pulse oximetry failed to decrease the cesarean rate or improve neonatal outcomes in a broader range of deliveries than has been studied previously. Chad K. Klauser, M.D., said at the annual meeting of the Central Association of Obstetricians and Gynecologists.

The U.S. Food and Drug Administration approved the use of fetal pulse oximetry (FPO) as an adjunct to fetal heart rate monitoring when the heart rate is nonreassuring, largely based on the results of a single randomized clinical trial by Thomas Garite, M.D. and colleagues, said Dr. Klauser, who is ob.gyn. house officer at the University of Mississippi Medical Center, Jackson.

Dr. Garite and his associates at nine medical centers had found that the technique halved the rate of cesarean sections performed because of nonreassuring fetal heart rate tracings in a study population of more than 1,000 women. However, FPO did not reduce the overall cesarean rate, nor did it improve neonatal outcomes, Dr. Klauser said.

He and his associates assessed whether FPO would similarly decrease cesarean sections in a broader range of deliveries, including preterm deliveries and pregnancies complicated by conditions such as chorioamnionitis. In his study of 327 women presenting in labor at 28 weeks' gestation or more, 150 underwent fetal monitoring plus FPO, and 177 underwent fetal monitoring alone, serving as controls.

The two groups were well matched for maternal race, age, and rate of nulliparity. The rates and types of antenatal complications were similar, as were the number of inductions, use of oxytocin, and rates of meconium staining.

Cervical dilatation and station at presentation also were similar between the two groups, as were the indications for cesarean delivery.

The use of FPO did not decrease the overall cesarean rate.