Fetal monitoring during the active second stage of labor

Journal de gynécologie, obstétrique et biologie de la reproduction
O Dupuis, A Simon

Abstract

To determine the best way of fetal monitoring during the active second stage of labor. Articles were searched using PubMed and Cochrane library. Active phase of labor begins with the onset of maternal pushing. It is characterised by frequent and prolonged uterine contractions as well as maternal bearing down efforts. Altogether those mechanical forces lead to an intrauterine pressure increase up to 250 mm Hg and to a marked reduction in placental perfusion. A prolonged period of expulsion will lead to an impairment of fetal oxygenation as well as a rise in carbon dioxide level. Melchior's FHR classification is specific of the active second stage of labor and described five fetal heart rate patterns: from type 0 to type 4. A reduction in pH and a rise in lactate and P(CO2) values occurred as one progresses from type 0 to type 4 (NP4). During the active phase of labor every method has a significant rate of signal loss. Loss of sensor contact occurred in up to 64% of time with oximetry, 35 to 48% of recordings obtained via external Doppler sensors have more than 20% of signal loss. Even 8 to 11% of recordings obtained via scalp sensors have more than 20% of signal loss. Fetal scalp blood sampling does not allow a continuous record...Continue Reading

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Citations

Sep 13, 2014·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Isabelle DehaeneGeert Page
Jun 23, 2015·Journal de gynécologie, obstétrique et biologie de la reproduction·N CheurfaP Deruelle
Sep 1, 2015·Journal de gynécologie, obstétrique et biologie de la reproduction·J-P BouillerG Benoist
Sep 28, 2014·Journal de gynécologie, obstétrique et biologie de la reproduction·A BourtembourgD Riethmuller
Aug 11, 2012·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Andrea L Tranquilli
Apr 27, 2020·Gynécologie, Obstétrique, Fertilité & Sénologie·C BenzekriC Garabedian

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