Transabdominal fetal pulse oximetry with near-infrared spectroscopy.

OBJECTIVE The purpose of this study was to determine the feasibility of noninvasive fetal pulse oximetry in the human fetus with transabdominal continuous-wave near-infrared spectroscopy. STUDY DESIGN The instrument has 3 wavelength light-emitting diodes (735, 805, and 850 nm) as light sources and a photomultiplier tube as a detector. This instrument was used in 6 pregnant women (>36 weeks of gestation). First, a fetal heart rate was obtained with a fetal heart rate monitor. Then, the depth of fetal tissue (head) from the maternal abdomen was determined by ultrasound examination; the distance between the optodes (light source and the detector) was set to be approximately twice the depth of the fetus (7-11 cm). The data analysis was based on the modified Beer-Lambert law and the use of optical densities at 735 and 850 nm to obtain the concentration changes of the oxyhemoglobin and deoxyhemoglobin. The saturation was expressed as the percent of oxygen saturation equal to 100 x oxyhemoglobin/(oxyhemoglobin + deoxyhemoglobin). We recorded the spectroscopy data and the fetal heart rate for approximately 3 to 10 minutes in each patient. RESULTS The mean oxygen saturation values of each of the 6 individual fetuses ranged from 50% to 74% (overall mean saturation, 61% +/- 14.8% [SD]). CONCLUSION This preliminary data indicate that transabdominal fetal pulse oximetry is feasible for human patient application. The measured values were similar to those that are obtained with transvaginal pulse oximetry. Future studies should correlate transabdominally obtained measurements with those measurements that are obtained by transvaginal fetal pulse oximetry.

[1]  D. Delpy,et al.  Measurement of Cranial Optical Path Length as a Function of Age Using Phase Resolved Near Infrared Spectroscopy , 1994 .

[2]  R. Donham,et al.  Accuracy of pulse oximetry during arterial oxyhemoglobin desaturation in dogs. , 1988, Anesthesiology.

[3]  N. Berkane,et al.  Multicenter study on the clinical value of fetal pulse oximetry. I. Methodologic evaluation. The French Study Group on Fetal Pulse Oximetry. , 1997, American journal of obstetrics and gynecology.

[4]  S. Arulkumaran,et al.  Intrapartum fetal pulse oximetry. Part 2: Clinical application. , 2000, Obstetrical & gynecological survey.

[5]  D B Swedlow,et al.  A multicenter controlled trial of fetal pulse oximetry in the intrapartum management of nonreassuring fetal heart rate patterns. , 2000, American journal of obstetrics and gynecology.

[6]  Mark Cope,et al.  Cerebral hemoglobin concentration and oxygen saturation measured by intensity modulated optical spectroscopy in the human fetus during labor , 2002, Journal of perinatal medicine.

[7]  M. E. Fein,et al.  Physio-optical considerations in the design of fetal pulse oximetry sensors. , 1997, European journal of obstetrics, gynecology, and reproductive biology.

[8]  F. Jöbsis Noninvasive, infrared monitoring of cerebral and myocardial oxygen sufficiency and circulatory parameters. , 1977, Science.

[9]  F. Maillard,et al.  Multicenter study on the clinical value of fetal pulse oximetry. II. Compared predictive values of pulse oximetry and fetal blood analysis. The French Study Group on Fetal Pulse Oximetry. , 1997, American Journal of Obstetrics and Gynecology.

[10]  D. Benaron,et al.  Imaging Brain Injury Using Time-Resolved Near Infrared Light Scanning , 1996, Pediatric Research.

[11]  N Ramanujam,et al.  Photon migration through fetal head in utero using continuous wave, near-infrared spectroscopy: development and evaluation of experimental and numerical models. , 2000, Journal of biomedical optics.

[12]  D. Boas,et al.  Trans-abdominal monitoring of fetal arterial blood oxygenation using pulse oximetry. , 2000, Journal of biomedical optics.

[13]  M. Heupel,et al.  The prediction of fetal acidosis by means of intrapartum fetal pulse oximetry. , 1999, American journal of obstetrics and gynecology.

[14]  S. Arridge,et al.  Estimation of optical pathlength through tissue from direct time of flight measurement , 1988 .

[15]  A Hielscher,et al.  Photon migration through fetal head in utero using continuous wave, near infrared spectroscopy: clinical and experimental model studies. , 2000, Journal of biomedical optics.

[16]  Britton Chance,et al.  Transabdominal near infrared oximetry of hypoxic stress in fetal sheep brain in utero , 2003, Proceedings of the National Academy of Sciences of the United States of America.

[17]  D T Delpy,et al.  Changes in human fetal cerebral hemoglobin concentration and oxygenation during labor measured by near-infrared spectroscopy. , 1992, American journal of obstetrics and gynecology.

[18]  F. Maillard,et al.  [Clinical importance of fetal pulse oximetry. II. Comparative predictive values of oximetry and scalp pH. Multicenter study]. , 1999, Journal de gynecologie, obstetrique et biologie de la reproduction.

[19]  S L Jacques,et al.  Modeling photon transport in transabdominal fetal oximetry. , 2000, Journal of biomedical optics.

[20]  W. Friedmann,et al.  Correlation of fetal oxygen saturation to fetal heart rate patterns, Evaluation of fetal pulse oximetry with two different oxisensors , 1998, Acta obstetricia et gynecologica Scandinavica.

[21]  S Nioka,et al.  Human brain functional imaging with reflectance CWS. , 1997, Advances in experimental medicine and biology.

[22]  D. Nochimson,et al.  The fetal biophysical profile and its predictive value. , 1983, Obstetrics and gynecology.

[23]  C. East,et al.  Fetal pulse oximetry. Instrumentation and recent clinical experience. , 1999, Clinics in perinatology.