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Is intrapartum vibratory acoustic stimulation a valid alternative to fetal scalp pH determination?

  1. Olivier Irion Invited Professor (Obstetrics and Gynaecology)1,*,
  2. Pierre Stuckelberger Fellow3,
  3. Jean-Marie Moutquin Professor (Obstetrics and Gynaecology)1,
  4. Alfredo Morabia Director (Clinical Epidemiology)2,
  5. Philippe Extermann Attending Physician3,
  6. Frangois Béguin Professor (Obstetrics and Gynaecology)3

Article first published online: 19 AUG 2005

DOI: 10.1111/j.1471-0528.1996.tb09831.x

Issue

BJOG: An International Journal of Obstetrics & Gynaecology

BJOG: An International Journal of Obstetrics & Gynaecology

Volume 103, Issue 7, pages 642–647, July 1996

Additional Information

How to Cite

Irion, O., Stuckelberger, P., Moutquin, J.-M., Morabia, A., Extermann, P. and Béguin, F. (1996), Is intrapartum vibratory acoustic stimulation a valid alternative to fetal scalp pH determination?. BJOG: An International Journal of Obstetrics & Gynaecology, 103: 642–647. doi: 10.1111/j.1471-0528.1996.tb09831.x

Author Information

  1. 1

    Centre de Recherche, Hôpital Saint-François d'dssise, Département de Gynécologie et d'obstétrique, Université Laval, Québec, Canada

  2. 2

    Division S Epidékmiologie Clinique, Département de Médecine Communautaire, Hôpitaux Universitaires de Genève, Switzerland

  3. 3

    Département de Gynécologie et d'obstétrique, Hôpitaux Universitaires de Genève, Switzerland.

*Correspondence: Dr O. Irion, Department of Obstetrics and Gynaecology, Cantonal Hospital, University of Geneva, CH-12II Geneva 14, Switzerland.

Publication History

  1. Issue published online: 19 AUG 2005
  2. Article first published online: 19 AUG 2005
  3. Received 25 May 1995 Accepted 21 November 1995

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Objective To determine the association between fetal heart rate accelerations, whether spontaneous or induced by vibratory acoustic stimulation, and subsequent scalp pH values in presence of a suspicious intraparturn fetal heart rate tracing, and thereby assess the ability of accelerations to predict a concurrent normal fetal scalp blood pH.

Design Prospective observational study of 253 labours involving 421 pH samples.

Setting Tertiary care university hospital of Geneva.

Intervention Vibratory acoustic stimulation through the maternal abdominal wall for five seconds prior to fetal blood sampling.

Main outcome measures Spontaneous fetal heart rate reactivity (accelerations) in the 10 min preceding vibratory acoustic stimulation, vibratory acoustic-induced reactivity prior to fetal blood sampling, and scalp pH value.

Results The positive predictive value of a reactive fetal heart rate response after vibratory acoustic stimulation was 78% (95% CI 73–84%) and 97% (95% CI 94–99%) for scalp pH values of > 7.25 and ≥ 7.20, respectively. Similar observations occurred with spontaneous reactivity. Of concern, 7 out of 31 (23%) occasions where the scalp blood pH was less than 7–20 appeared to be associated with a normal fetal heart rate response to vibratory acoustic stimulation.

Conclusions Fetal heart rate acceleration induced by vibratory acoustic stimulation was significantly associated with a normal scalp blood pH higher than 7.25. However, vibratory acoustic stimulation offers no advantage over observation of spontaneous fetal heart rate tracings and cannot safely replace fetal blood sampling during labour.

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