Intrapartum fetal monitoring

Intrapartum fetal monitoring is a set of methods used to prevent fetal hypoxia in an attempt to prevent the consequences of hypoxia (hypoxic-ischemic encephalopathy, fetal death). The goal is to distinguish unaltered fetuses, altered fetuses with a preserved ability to compensate (increased blood floe, change in metabolism) and altered fetuses that are no longer capable of compesation.

Currently, mainly three different methods are used: cardiotocography (CTG), fetal ECG (ST-analysis, STAN) and fetal pulse oxymetry (FPO). Saling's method of determing blood gases from a drop of blood taken from child's head is rarely used.



Cardiotocography
Cardiotocography (CTG) is a method of fetal monitoring using the simultaneous recording of fetal heart rate ( cardiotachogram ) and uterine contractions ( tocogram ). Modern devices enable a third signal modality in the form of recording fetal movements. The method is based on the fact that hypoxic changes affect the hemodynamics of the fetus and changes in the uteroplacental circulation will be manifested by a change in the frequency of fetal echoes.

Independent CTG diagnosis is in agreement with the diagnosis of hypoxia of the newborn after birth in 50-60% [1]. The simultaneous use of CTG and STAN will reduce the incidence of metabolic acidosis by 60% and the number of operations for fetal distress by 25%.

Physiology of uterine contraction

Salingova metoda
Salingova metoda je mikroodběr kapky krve z hlavičky plodu ke stanovení krevních plynů. Jednorázový odběr nemonitoruje plod kontinuálně, opakované odběry jsou velmi náročné a příliš invazivní (mutilující), proto se metoda příliš nepoužívá.

Související články

 * Kardiopulmonální resuscitace novorozence
 * Hypoxie novorozence • Hypoxicko-ischemická encefalopatie
 * Diagnostika stavu plodu v těhotenství a při porodu • Hypoxie plodu