Fetal cerebral monitoring during the second stage of labor

Abstract

The moment of perinatal hypoxic injury is still difficult to be identified by current monitoring techniques. Recent studies highlights that the effectiveness of therapy in hypoxic ischemic encephalopathy, such as therapeutic hypothermia and antioxidant agents, is determined by the time elapsed from the moment of injury to the begining of intervention. Twenty six term newborns were analyzed, 13 from vaginal delivery and 13 extracted by cesarean section. The group selection criteria were: term pregnancy (gestation age ≥ 37 weeks), normal labor, cranial presentation, without fetal malformations and normal neonatal transition. We believe that additional fetal brain monitoring (NIRS and/or aEEG) can predict fetal brain events due to severe prepartum acidosis. Intrauterine fetal cerebral saturation is at the lower limit of postnatal neonatal cerebral saturation. FTOE is maximum during vaginal or cesarian section delivery compared to those in the first 10 min of life. The mode of delivery does not significantly affect FTOE or placental oxygen blood supply. Because the hypoxic - ischemic injury has accurred during late decelerations, consider it necessary to identify hypoxic markers prior to detection of this typ of FHR .