Edwin Chandraharan has no commercial interests or links with any non-NHS organizations. Nana Wiberg has no financial affiliation or involvement with any commercial organization with potential financial interest in the subject or materials discussed in this article.
Fetal scalp blood sampling during labor: an appraisal of the physiological basis and scientific evidence
Article first published online: 28 MAY 2014
© 2014 Nordic Federation of Societies of Obstetrics and Gynecology
Acta Obstetricia et Gynecologica Scandinavica
Special Issue: Fetal Monitoring, Guest Editor: Jens Langhoff-Roos
Volume 93, Issue 6, pages 544–547, June 2014
How to Cite
Fetal scalp blood sampling during labor: an appraisal of the physiological basis. Acta Obstet Gynecol Scand 2014; 93:544–547., .
- Issue published online: 28 MAY 2014
- Article first published online: 28 MAY 2014
- Accepted manuscript online: 8 MAY 2014 02:05AM EST
- Manuscript Accepted: 1 MAY 2014
- Manuscript Received: 1 APR 2014
- fetal scalp blood sampling;
- Cochrane systematic review;
- instrumental delivery;
- fetal surveillance
Fetal cardiotocography is characterized by low specificity; therefore, in an attempt to ensure fetal well-being, fetal scalp blood sampling has been recommended by most obstetric societies in the case of a non-reassuring cardiotocography. The scientific agreement on the evidence for using fetal scalp blood sampling to decrease the rate of operative delivery for fetal distress is ambiguous. Based on the same studies, a Cochrane review states that fetal scalp blood sampling increases the rate of instrumental delivery while decreasing neonatal acidosis, whereas the National Institute of Health and Clinical Excellence guideline considers that fetal scalp blood sampling decreases instrumental delivery without differences in other outcome variables. The fetal scalp is supplied by vessels outside the skull below the level of the cranial vault, which is likely to be compressed during contractions. The self-regulated redistribution of oxygenated blood from peripheral to central organs causes peripheral ischemia, thus theoretically bringing into question the scalp capillary bed as representative of the central circulation.