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Pulse oximetry--physiological considerations

M A Hanson1, J G Nijhuis

  • 1Department of Obstetrics and Gynaecology, University College London Medical School, UK.

European Journal of Obstetrics, Gynecology, and Reproductive Biology
|March 1, 1997
PubMed
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Assessing fetal well-being with pulse oximetry is challenging. Hemoglobin oxygen saturation (SaO2) and other factors like blood flow and tissue oxidation require further research for reliable intrapartum monitoring.

Area of Science:

  • Obstetrics and Gynecology
  • Fetal Physiology
  • Medical Diagnostics

Background:

  • Fetal well-being is critically dependent on oxygenation of vital organs like the heart and brain.
  • Intrapartum monitoring aims to assess fetal condition during labor and delivery.
  • Pulse oximetry is a potential tool for evaluating fetal oxygenation.

Purpose of the Study:

  • To review the physiological parameters influencing the use of pulse oximetry for intrapartum fetal assessment.
  • To identify limitations and challenges in using hemoglobin oxygen saturation (SaO2) for fetal well-being evaluation.

Main Methods:

  • Review of physiological parameters relevant to fetal oxygenation and pulse oximetry.
  • Discussion of the relationship between partial pressure of oxygen (PO2) and SaO2.

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  • Analysis of factors affecting oxygen content, delivery, and tissue oxidation.

    • Main Results:

    • The relationship between PO2 and SaO2 is nonlinear and insensitive at high physiological ranges.
    • SaO2 measurement is affected by the Bohr shift.
    • Accurate assessment of oxygen delivery requires simultaneous measurement of hemoglobin (Hb) content and blood flow.
    • Evaluating tissue oxygenation necessitates measures like cytochrome aa3 oxidation, which can be altered by local vascular and metabolic changes.

    Conclusions:

    • The use of SaO2 alone to assess fetal well-being intrapartum presents significant difficulties.
    • Further research is essential before routine clinical application of pulse oximetry for fetal monitoring can be considered.