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Fetal Circulation

Fetal Circulation

Fetal circulation is a unique system that facilitates the exchange of gases, nutrients, and waste products between the developing fetus and the mother. This intricate process takes place through a special organ called the placenta.
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...

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Fetal Mouse Cardiovascular Imaging Using a High-frequency Ultrasound 30/45MHZ System

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Using the CAESARE tool in fetal heart rate analysis.

Simon Hubert¹, Océane Brodbeck¹, Claire David¹

¹Troyes Hospital: Gynecology and Obstetrics Service, 101 Avenue Anatole France, Troyes 10000, France.

Journal of Gynecology Obstetrics and Human Reproduction

|February 21, 2023

Summary

The CAESARE tool, based on fetal heart rate, can reduce cesarean section rates for non-reassuring fetal status (NRFS) without increasing neonatal asphyxiation risk. This decision-making aid improves clinical judgment in labor management.

Keywords:

CAESARE tool Cardiotocography Cesarean Fetal heart rate

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Last Updated: Aug 9, 2025

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Published on: January 7, 2021

Area of Science:

Obstetrics and Gynecology
Fetal Monitoring
Clinical Decision Support Systems

Background:

Cesarean section rates are a significant concern in modern obstetrics.
Non-reassuring fetal status (NRFS) during labor is a primary indication for cesarean delivery.
Accurate and timely decision-making is crucial to balance maternal and fetal well-being.

Purpose of the Study:

To evaluate the theoretical impact of the CAESARE decision-making tool on cesarean delivery rates.
To assess the tool's effectiveness in preventing metabolic acidosis risk in newborns.
To analyze the influence of the CAESARE tool on clinical decision-making processes for NRFS.

Main Methods:

Observational, multicenter, retrospective study (2018-2020) of term cesarean sections for NRFS.
Comparison of actual cesarean rates with theoretical rates predicted by the CAESARE tool.
Analysis of newborn umbilical cord arterial pH as a secondary outcome.
Single-blinded assessment by midwives and obstetric gynecologists using the CAESARE tool.

Main Results:

The CAESARE tool influenced decision-making, with proposed vaginal deliveries in 86% of cases by OB-GYNs (p<0.01).
A difference in umbilical cord arterial pH was observed, indicating potential impact on neonatal outcomes.
The tool expedited decisions for cesarean delivery in cases of low umbilical cord arterial pH (<7.1).
Kappa coefficient of 0.62 indicates good agreement in decision-making.

Conclusions:

The CAESARE decision-making tool shows potential to reduce cesarean births for NRFS.
The tool appears to manage the risk of neonatal asphyxiation effectively.
Further prospective studies are recommended to confirm these findings and assess long-term neonatal outcomes.