Fetal pulse oximetry and cesarean delivery

Steven L. Bloom, Catherine Y. Spong, Elizabeth Thom, Michael W. Varner, Dwight J. Rouse, Sandy Weininger, Susan M. Ramin, Steve N. Caritis, Alan Peaceman, Yoram Sorokin, Anthony Sciscione, Marshall Carpenter, Brian Mercer, John Thorp, Fergal Malone, Margaret Harper, Jay Iams, Garland Anderson

Research output: Contribution to journalArticle

97 Citations (Scopus)

Abstract

BACKGROUND: Knowledge of fetal oxygen saturation, as an adjunct to electronic fetal monitoring, may be associated with a significant change in the rate of cesarean deliveries or the infant's condition at birth. METHODS: We randomly assigned 5341 nulliparous women who were at term and in early labor to either "open" or "masked" fetal pulse oximetry. In the open group, fetal oxygen saturation values were displayed to the clinician. In the masked group, the fetal oxygen sensor was inserted and the values were recorded by computer, but the data were hidden. Labor complicated by a nonreassuring fetal heart rate before randomization was documented for subsequent analysis. RESULTS: There was no significant difference in the overall rates of cesarean delivery between the open and masked groups (26.3% and 27.5%, respectively; P = 0.31). The rates of cesarean delivery associated with the separate indications of a nonreassuring fetal heart rate (7.1% and 7.9%, respectively; P = 0.30) and dystocia (18.6% and 19.2%, respectively; P = 0.59) were similar between the two groups. Similar findings were observed in the subgroup of 2168 women in whom a nonreassuring fetal heart rate was detected before randomization. The condition of the infants at birth did not differ significantly between the two groups. CONCLUSIONS: Knowledge of the fetal oxygen saturation is not associated with a reduction in the rate of cesarean delivery or with improvement in the condition of the newborn. (ClinicalTrials.gov number, NCT00098709.)

Original languageEnglish (US)
Pages (from-to)2195-2202
Number of pages8
JournalNew England Journal of Medicine
Volume355
Issue number21
DOIs
StatePublished - Nov 23 2006

Fingerprint

Oximetry
Fetal Heart Rate
Oxygen
Random Allocation
Parturition
Cardiotocography
Dystocia
Newborn Infant

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Bloom, S. L., Spong, C. Y., Thom, E., Varner, M. W., Rouse, D. J., Weininger, S., ... Anderson, G. (2006). Fetal pulse oximetry and cesarean delivery. New England Journal of Medicine, 355(21), 2195-2202. https://doi.org/10.1056/NEJMoa061170

Fetal pulse oximetry and cesarean delivery. / Bloom, Steven L.; Spong, Catherine Y.; Thom, Elizabeth; Varner, Michael W.; Rouse, Dwight J.; Weininger, Sandy; Ramin, Susan M.; Caritis, Steve N.; Peaceman, Alan; Sorokin, Yoram; Sciscione, Anthony; Carpenter, Marshall; Mercer, Brian; Thorp, John; Malone, Fergal; Harper, Margaret; Iams, Jay; Anderson, Garland.

In: New England Journal of Medicine, Vol. 355, No. 21, 23.11.2006, p. 2195-2202.

Research output: Contribution to journalArticle

Bloom, SL, Spong, CY, Thom, E, Varner, MW, Rouse, DJ, Weininger, S, Ramin, SM, Caritis, SN, Peaceman, A, Sorokin, Y, Sciscione, A, Carpenter, M, Mercer, B, Thorp, J, Malone, F, Harper, M, Iams, J & Anderson, G 2006, 'Fetal pulse oximetry and cesarean delivery', New England Journal of Medicine, vol. 355, no. 21, pp. 2195-2202. https://doi.org/10.1056/NEJMoa061170
Bloom SL, Spong CY, Thom E, Varner MW, Rouse DJ, Weininger S et al. Fetal pulse oximetry and cesarean delivery. New England Journal of Medicine. 2006 Nov 23;355(21):2195-2202. https://doi.org/10.1056/NEJMoa061170
Bloom, Steven L. ; Spong, Catherine Y. ; Thom, Elizabeth ; Varner, Michael W. ; Rouse, Dwight J. ; Weininger, Sandy ; Ramin, Susan M. ; Caritis, Steve N. ; Peaceman, Alan ; Sorokin, Yoram ; Sciscione, Anthony ; Carpenter, Marshall ; Mercer, Brian ; Thorp, John ; Malone, Fergal ; Harper, Margaret ; Iams, Jay ; Anderson, Garland. / Fetal pulse oximetry and cesarean delivery. In: New England Journal of Medicine. 2006 ; Vol. 355, No. 21. pp. 2195-2202.
@article{80fd0c7abd4c4c849641a3b7ef5afaae,
title = "Fetal pulse oximetry and cesarean delivery",
abstract = "BACKGROUND: Knowledge of fetal oxygen saturation, as an adjunct to electronic fetal monitoring, may be associated with a significant change in the rate of cesarean deliveries or the infant's condition at birth. METHODS: We randomly assigned 5341 nulliparous women who were at term and in early labor to either {"}open{"} or {"}masked{"} fetal pulse oximetry. In the open group, fetal oxygen saturation values were displayed to the clinician. In the masked group, the fetal oxygen sensor was inserted and the values were recorded by computer, but the data were hidden. Labor complicated by a nonreassuring fetal heart rate before randomization was documented for subsequent analysis. RESULTS: There was no significant difference in the overall rates of cesarean delivery between the open and masked groups (26.3{\%} and 27.5{\%}, respectively; P = 0.31). The rates of cesarean delivery associated with the separate indications of a nonreassuring fetal heart rate (7.1{\%} and 7.9{\%}, respectively; P = 0.30) and dystocia (18.6{\%} and 19.2{\%}, respectively; P = 0.59) were similar between the two groups. Similar findings were observed in the subgroup of 2168 women in whom a nonreassuring fetal heart rate was detected before randomization. The condition of the infants at birth did not differ significantly between the two groups. CONCLUSIONS: Knowledge of the fetal oxygen saturation is not associated with a reduction in the rate of cesarean delivery or with improvement in the condition of the newborn. (ClinicalTrials.gov number, NCT00098709.)",
author = "Bloom, {Steven L.} and Spong, {Catherine Y.} and Elizabeth Thom and Varner, {Michael W.} and Rouse, {Dwight J.} and Sandy Weininger and Ramin, {Susan M.} and Caritis, {Steve N.} and Alan Peaceman and Yoram Sorokin and Anthony Sciscione and Marshall Carpenter and Brian Mercer and John Thorp and Fergal Malone and Margaret Harper and Jay Iams and Garland Anderson",
year = "2006",
month = "11",
day = "23",
doi = "10.1056/NEJMoa061170",
language = "English (US)",
volume = "355",
pages = "2195--2202",
journal = "New England Journal of Medicine",
issn = "0028-4793",
publisher = "Massachussetts Medical Society",
number = "21",

}

TY - JOUR

T1 - Fetal pulse oximetry and cesarean delivery

AU - Bloom, Steven L.

AU - Spong, Catherine Y.

AU - Thom, Elizabeth

AU - Varner, Michael W.

AU - Rouse, Dwight J.

AU - Weininger, Sandy

AU - Ramin, Susan M.

AU - Caritis, Steve N.

AU - Peaceman, Alan

AU - Sorokin, Yoram

AU - Sciscione, Anthony

AU - Carpenter, Marshall

AU - Mercer, Brian

AU - Thorp, John

AU - Malone, Fergal

AU - Harper, Margaret

AU - Iams, Jay

AU - Anderson, Garland

PY - 2006/11/23

Y1 - 2006/11/23

N2 - BACKGROUND: Knowledge of fetal oxygen saturation, as an adjunct to electronic fetal monitoring, may be associated with a significant change in the rate of cesarean deliveries or the infant's condition at birth. METHODS: We randomly assigned 5341 nulliparous women who were at term and in early labor to either "open" or "masked" fetal pulse oximetry. In the open group, fetal oxygen saturation values were displayed to the clinician. In the masked group, the fetal oxygen sensor was inserted and the values were recorded by computer, but the data were hidden. Labor complicated by a nonreassuring fetal heart rate before randomization was documented for subsequent analysis. RESULTS: There was no significant difference in the overall rates of cesarean delivery between the open and masked groups (26.3% and 27.5%, respectively; P = 0.31). The rates of cesarean delivery associated with the separate indications of a nonreassuring fetal heart rate (7.1% and 7.9%, respectively; P = 0.30) and dystocia (18.6% and 19.2%, respectively; P = 0.59) were similar between the two groups. Similar findings were observed in the subgroup of 2168 women in whom a nonreassuring fetal heart rate was detected before randomization. The condition of the infants at birth did not differ significantly between the two groups. CONCLUSIONS: Knowledge of the fetal oxygen saturation is not associated with a reduction in the rate of cesarean delivery or with improvement in the condition of the newborn. (ClinicalTrials.gov number, NCT00098709.)

AB - BACKGROUND: Knowledge of fetal oxygen saturation, as an adjunct to electronic fetal monitoring, may be associated with a significant change in the rate of cesarean deliveries or the infant's condition at birth. METHODS: We randomly assigned 5341 nulliparous women who were at term and in early labor to either "open" or "masked" fetal pulse oximetry. In the open group, fetal oxygen saturation values were displayed to the clinician. In the masked group, the fetal oxygen sensor was inserted and the values were recorded by computer, but the data were hidden. Labor complicated by a nonreassuring fetal heart rate before randomization was documented for subsequent analysis. RESULTS: There was no significant difference in the overall rates of cesarean delivery between the open and masked groups (26.3% and 27.5%, respectively; P = 0.31). The rates of cesarean delivery associated with the separate indications of a nonreassuring fetal heart rate (7.1% and 7.9%, respectively; P = 0.30) and dystocia (18.6% and 19.2%, respectively; P = 0.59) were similar between the two groups. Similar findings were observed in the subgroup of 2168 women in whom a nonreassuring fetal heart rate was detected before randomization. The condition of the infants at birth did not differ significantly between the two groups. CONCLUSIONS: Knowledge of the fetal oxygen saturation is not associated with a reduction in the rate of cesarean delivery or with improvement in the condition of the newborn. (ClinicalTrials.gov number, NCT00098709.)

UR - http://www.scopus.com/inward/record.url?scp=33751247637&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33751247637&partnerID=8YFLogxK

U2 - 10.1056/NEJMoa061170

DO - 10.1056/NEJMoa061170

M3 - Article

C2 - 17124017

AN - SCOPUS:33751247637

VL - 355

SP - 2195

EP - 2202

JO - New England Journal of Medicine

JF - New England Journal of Medicine

SN - 0028-4793

IS - 21

ER -