Fetal Monitoring
Conditions
Keywords
CTG, Fetal blood sampling - Lactate, ST waveform analysis
Brief summary
The main aim of the study is to compare the clinical performance of two adjunctive methods to CTG in intrapartum fetal monitoring: FBS with measurement of scalp lactate and ST analysis of the fetal ECG.
Detailed description
We use Lactate as a standard adjunctive method in our hospital but we have STAN software available ( is demasked) in our CTG monitors. We will include all women in labour with an intern scalp monitoring and analyse the CTG, the lactate samples and the STAN signals in the same patient and * Study the relationship between the decision-to-delivery interval and neonatal morbidity in deliveries monitored by scalp lactate measurement * Compare the diagnostic capability of both methods to identify fetuses at risk of hypoxia * Compare the false negative alerts from both methods * Explore the temporal and quantitative relation between fetal lactate metabolism and ST interval changes of the fetal ECG * Investigate the occurrence of fetal extrasystoles during labor and to assess their association with short-term neonatal outcomes
Interventions
DIAGNOSTIC_TESTSTAN ( St wave analysis) and fetal blood sample-lactate
The CTG will be analysed by an expert group additional to the standard procedure that have been done in Labour already. The STAN analysis will be decrypted/ demasked anonymously by the Company producing these machines.
Sponsors
Oslo University Hospital
Haukeland University Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 60 Years
Healthy volunteers
Yes
Inclusion criteria
* Singleton pregnancy * Cephalic presentation * Gestational age ≥36+0 weeks at delivery * Presence of antpartum or intrapartum risk factors for fetal hypoxia according to Norwegian guidelines and therefore indication for electronic fetal monitoring with scalp electrode .
Exclusion criteria
* Multiple pregnancies * Breech presentation * Gestational age \< 36+0 weeks * Contraindications for placement of a scalp electrode (HIV or HBV or HCV pos)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Is fetal hypoxia (defined as arterial umbilical cord pH < 7,1 postpartum) superiorly identified by fetal scalp blood sampling (lactate) or ST analysis of fetal ECG | 2019-2022 | 1. Compare the diagnostic capability of both methods to identify fetuses at risk of hypoxia (i.e.umbilical artery blood pH ≤7.1) 2. Compare FBS lactate with STAN in order to identify the superior method to avoid cord-blood acidosis at birth (i.e.umbilical artery blood pH \>7.1) 3. Compare the true negative alerts from both methods, specificity |
| Is cord blood acidosis, measured as pH in the umbilical artery postpartum affected by the "Decision-to-delivery interval" measured in minutes from Lactate warning until delivery. | 2019-2022 | To assess the effect of increasing time interval from the objective warning of intrapartum fetal hypoxia with fetal scalp lactate ≥ 4.8mmol/l to the end of operative delivery on the percentage of moderate cord-blood acidosis at birth (i.e., umbilical artery blood pH ≤ 7.1) |
Countries
Norway
Contacts
STUDY_DIRECTORJacobsen F Anne Flem, MD, PhD
OUH
Outcome results
None listed