RELATION BETWEEN FREQUENCY OF UTERINE CONTRACTIONS AND HUMAN FETAL CEREBRAL OXYGEN-SATURATION STUDIED DURING LABOR BY NEAR-INFRARED SPECTROSCOPY

Objective To investigate the effect of the frequency of uterine contractions on fetal cerebral oxygenation, using near infrared spectroscopy. Design An observational study relating changes in the fetal cerebral concentrations of oxyhaemoglobin and deoxyhaemoglobin, measured from the start of one contraction to that of the next, to the time interval between contraction peaks observed by external tocography. Setting A teaching hospital obstetric and neonatal unit. Subjects Ten term fetuses during labour. Results Changes in cerebral oxyhaemoglobin concentration were positively, and in deoxyhaemoglobin negatively, correlated with the time interval between contractions (P <0.001). A mean contraction interval of 2.3 min was found below which the concentration of oxyhaemoglobin usually fell and that of deoxyhaemoglobin rose, indicating a fall in cerebral haemoglobin saturation. Conversely, longer contraction intervals were associated with findings indicative of a rise in cerebral haemoglobin saturation. Conclusion Short contraction intervals (<2.3 min) were associated with a decrease, and longer contraction intervals with an increase in fetal cerebral oxygen saturation. Contractions occurring repeatedly at intervals less than 2.3 min are likely to result in progressive cerebral desaturation.