VCU news

By Michael Ford
University News Services

RICHMOND, Va. – Virginia Commonwealth University’s Medical College of Virginia Hospitals is the state’s first medical center to offer a new FDA approved fetal- monitoring technology that may cut in half the number of Caesarean deliveries done because of fetal distress. Due in part to early research by a VCU physician, fetal-pulse oximetry is designed to give doctors more accurate information about oxygen levels in a baby during labor and delivery.

During their patient’s labor, doctors make decisions about performing emergency Caesarean sections based on information dealing with fetal-heart rate related to fetal-oxygen levels. Fetal-pulse oximetry is the first direct method of measuring real-time fetal-oxygen levels during labor and delivery. Other monitoring methods, such as fetal heart-rate tracing and fetal stimulation, are more indirect markers of oxygenation.

John W. Seeds, M.D., VCU’s chairman of obstetrics and gynecology, said the new monitoring system will be used in conjunction with fetal heart-rate monitoring to give OB/GYN doctors at VCU’s MCV Hospitals the most comprehensive information about the condition of a baby during labor.

"Fetal pulse oximetry is an exciting new tool and the first major advance in our ability to safely take care of the baby in labor in 30 years," Seeds said. "We’ll use it selectively when electronic fetal heart rate monitoring suggests that the baby is having trouble. We anticipate using it on 15 to 20 percent of women in labor."

The fetal oxygen monitor works by shining infrared light through a sensor, which is inserted into the uterus and rests against the cheek of the fetus. The amount of light transmitted and reflected back through the baby’s skin provides a measure of how much oxygen is present in the baby’s blood. Oxygen-rich blood absorbs a different amount of infrared light than blood that doesn’t have oxygen. Information about oxygen levels can be paired with conventional heart-rate monitors to deliver companion printouts that document the condition of the fetus throughout delivery. Across the country, about 15 to 20 percent of C-sections may be done for fetal distress.

"Large studies already done suggest the use of fetal-pulse oximetry may safely allow us to decrease the rate of Caesarean delivery done for fetal distress by half," Seeds said.

In 1984, Seeds did the first basic research in the country into the use of infrared light technology to measure oxygen in the blood of a fetus. His findings from that three-year study were published in the American Journal of Obstetrics and Gynecology.