Re: Fetal Pulse Oximetry No Help
From: Joe (forcep@intercom.net)
Tue Feb 28 19:27:10 2006
Just a thought and my obvious bias: It would have been nice to have had
some evidence based medicine at the birth of electronic fetal
monitoring. Joe C
Elrod, Darryl G MAJ 48 MDOS/SGOBO wrote:
> But this is what they really told us when we first started using fetal
> pulsoximetry. The likelihood was that we wouldn't do less c-sections
> overall, we'd just do less for distress or non reassuring tracings, but
> more for arrest disorders.
>
> I thought Nelcor stopped manufacturing the model anyway?
>
> Glen
>
> //SIGNED//
>
> D. Glen Elrod, Maj., USAF, MC
>
> Obstetrician/Gynecologist
>
> Chief of Obstetrics
>
> 48 MDOS/SGOBO
>
> RAF Lakenheath, England
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> -----Original Message-----
> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of art
> fougner, md
> Sent: Tuesday, February 28, 2006 10:16 PM
> To: Multiple recipients of list OB-GYN-L
> Subject: OB: Fetal Pulse Oximetry No Help
>
>>From the latest Ob-Gyn News ...
>
> Fetal pulse oximetry failed to significantly decrease the cesarean
> delivery rate or to improve neonatal outcomes in a randomized,
> multicenter study of more than 5,000 women, Dr. Steven L. Bloom said
> at the annual meeting of the Society for Maternal-Fetal Medicine.
>
> "Unfortunately, the results of this study ... suggest that fetal
> oximetry
> has not realized its promise of reducing cesarean births," said Dr.
> Bloom, who presented the findings on behalf of the National Institute of
> Child Health and Human Development Maternal-Fetal Medicine Units Network
> in Bethesda, Md.
>
> Dr. Bloom and his associates randomized 2,629 nulliparous women at term
> in early labor to an "open oximetry" group; physicians delivering the
> babies of the women in this group could view fetal oxygen saturation
> values. For comparison, they randomized another 2,712 women to a
> "masked oximetry" group. The oximetry was an adjunct to continuous
> electronic fetal monitoring.
>
> A total of 692 women in the open group and 747 women in the masked group
> delivered via cesarean section (26.3% vs. 27.5%). A nonreassuring
> fetal heart rate was the reason for cesarean section for 187 women in
> the open group and 214 women in the masked group (7.1% vs. 7.9%).
> Dystocia was the reason for 490 women in the open group and 521 women in
> the masked group (18.6% vs. 19.2%).
>
> "The overall cesarean rate, as well as the rates of cesarean deliveries
> for specific indications, was not different," said Dr. Bloom, interim
> chair of the department of obstetrics and gynecology at the University
> of Texas Southwestern Medical Center in Dallas.
>
> http://www.obgynnews.com/article/PIIS0029743706714392/fulltext
>
> Art
>
> --
> art fougner, md
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