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Near-infrared spectroscopy for fetal assessment during labour

  • Review
  • Intervention

Authors

  • Ellen L Mozurkewich,

    Corresponding author
    1. University of New Mexico, Department of Obstetrics and Gynecology, School of Medicine, Albuquerque, New Mexico, USA
    • Ellen L Mozurkewich, Department of Obstetrics and Gynecology, School of Medicine, University of New Mexico, MSC 10 5580, 1, Albuquerque, New Mexico, 87131 0001, USA. emozurkewich@salud.unm.edu.

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  • Fredric M Wolf

    1. University of Washington School of Medicine, Department of Medical Education & Biomedical Informatics, Seattle, WA, USA
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Abstract

Background

Over the past four decades, continuous electronic fetal monitoring (EFM) has been increasingly employed to detect fetal acidaemia in labour, with a view toward prevention of hypoxic ischaemic encephalopathy, permanent neurologic injury, and death. Although very sensitive, this technology has low specificity, and a high false positive rate. This false positive rate has resulted in operative intervention on behalf of many fetuses who were not in fact in danger of neurologic injury or death. Near-infrared spectroscopy has been developed to directly measure fetal cerebral oxygenation, with a view toward identification of those fetuses truly at risk.

Objectives

To determine the effects of the use of near-infrared spectroscopy to assess fetal condition during labour, on maternal and perinatal outcomes.

Search methods

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (August 2009).

Selection criteria

Randomised trials comparing near-infrared spectroscopy with continuous EFM alone or continuous EFM and scalp pH.

Data collection and analysis

No trials were identified. If they had been, both authors would have assessed eligibility and trial quality.

Main results

No randomised trials were identified. Thus no studies were included.

Authors' conclusions

There is currently insufficient evidence to assess the efficacy of fetal surveillance by near-infrared spectroscopy.

Plain language summary

Near-infrared spectroscopy for fetal assessment during labour

There are no randomised trials that assess the effects of near-infrared spectroscopy monitoring for lack of oxygen to babies' brains during labour.

Near-infrared spectroscopy (NIRS) is a light-based way of measuring oxygen flows through the brain. It can be used to try and see if a fetus is at risk of brain injury from lack of oxygen during labour. NIRS involves inserting a cable through the cervix (opening of the womb) and next to the baby's head. Near-infrared light is then transmitted through the skull and brain. The review found no trials assessing the effects of NIRS in labour.

Laienverständliche Zusammenfassung

Nahinfrarot-Spektroskopie zur Untersuchung des Babys während der Geburt

Es gibt keine randomisierten kontrollierten Studien über die Wirkung von Nahinfrarot-Spektroskopie zur Überwachung von Sauerstoffmangel des kindlichen Gehirns während der Geburt.

Nahinfrarot-Spektroskopie (NIRS) ist eine auf Licht basierende Untersuchung der Sauerstoffversorgung des Gehirns. Mithilfe dieser Technik kann man während der Geburt versuchen das kindliche Risiko für einen Gehirnschaden infolge Sauerstoffmangel zu beurteilen. Bei der Anwendung von NIRS wird ein Kabel, durch den geöffneten Muttermund, direkt neben dem Kopf des Babys angebracht. Das Nah-Infrarotlicht durchleuchtet den Schädelknochen und das Gehirn. Für diese Übersicht wurden keine Studien gefunden, die die Bedeutung von Nahinfrarot-Spektroskopie bei der Geburt untersuchen.

Anmerkungen zur Übersetzung

Koordination durch Cochrane Schweiz

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