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Related Experiment Videos

[Fetal scalp pH during labor: Which threshold for intervention?]

C Morin1, M Chartier1, S Bounan2

  • 1Maternité Port-Royal, hôpital Cochin, DHU risques et grossesse, Assistance publique-Hôpitaux de Paris, 53, avenue de l'Observatoire, 75014 Paris, France.

Journal of Gynecology Obstetrics and Human Reproduction
|April 14, 2017
PubMed
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A lower scalp pH threshold of 7.20 for rapid birth may reduce cesarean rates without increasing adverse neonatal outcomes. Further research is needed to confirm safety regarding severe acidosis risks.

Area of Science:

  • Obstetrics and Gynecology
  • Neonatal Medicine
  • Perinatal Research

Background:

  • Consensus is lacking on the optimal scalp pH threshold for deciding on rapid birth during abnormal fetal heart rate.
  • Different maternity units may employ varying scalp pH decision thresholds, potentially impacting clinical outcomes.

Purpose of the Study:

  • To compare neonatal outcomes and cesarean delivery rates between two maternity units utilizing different scalp pH decision thresholds.
  • To evaluate the impact of a 7.20 versus a 7.25 scalp pH threshold on neonatal morbidity and operative delivery rates.

Main Methods:

  • A retrospective comparative study involving two level III maternity units from January 2013 to May 2014.
  • One unit used a scalp pH threshold of 7.20, while the other used 7.25.
Keywords:
Acidose fœtaleCesareanCésarienneFetal acidosisFetal scalp pHNeonatal issuepH au scalpÉtat néonatal

Related Experiment Videos

  • Adverse neonatal outcome was defined by a composite endpoint; cesarean risk was assessed via multivariate analysis.

    • Main Results:

    • No significant difference in adverse neonatal outcomes (25% vs. 30.1%) or average pH at birth was observed between the two groups.
    • The 7.20 scalp pH threshold group had a higher incidence of base excess (BE) less than -12 (7% vs. 0%).
    • The maternity unit with the 7.25 scalp pH threshold exhibited a higher cesarean rate (adjusted OR=2.23).

    Conclusions:

    • A scalp pH decision threshold of 7.20 appears reasonable and may lead to a reduction in cesarean rates.
    • Further studies are warranted to confirm that a 7.20 threshold does not elevate the risk of severe neonatal acidosis.
    • The findings suggest potential for optimizing intervention thresholds in fetal heart rate monitoring.