PROVO -- If an unborn baby is deprived of sufficient amounts of oxygen, the child could die -- or be born with brain damage or neurological disorders.
But thanks to research completed in part by a Provo doctor, such oxygen deficiencies can now be detected in the womb.Last week, doctors released the results of tests done in nine U.S. states that show fetal oxygen monitoring can have a dramatic impact on babies.
"Fetal oxygen monitoring allows me to measure the fundamental issue that I'm concerned about -- the fetal oxygen status," said Dr. Gary Dilde, director of maternal fetal medicine at Utah Valley Regional Medical Center in Provo.
Dilde participated in the clinical study that found fetal oxygen monitoring to be safe and effective while reducing the need for Caesarean deliveries by 50 percent in the test group of 1,000 births.
Doctors used light readings from a disposable sensor to measure the amount of oxygen in the baby's blood. The sensor is inserted through the birth canal and placed against the cheek, forehead or temple of the baby.
Harmless red and infrared light shines onto the baby's skin, and the reflected light is captured and analyzed.
The amount of oxygen saturation is then displayed on a monitor as a percentage. Normal oxygen saturation is usually between 30 percent and 70 percent.
Using a fetal oxygen monitor in conjunction with fetal heart monitoring will enhance the ability of the obstetrician, the midwife and parents to decide if all is well or if intervention is needed, Dilde said.
"We all try to remember for our patients that the birthing process is a very natural thing," said Dr. Thomas Garite, director of obstetrics and gynecology at the University of California, Irvine, and lead investigator in the clinical trial.
"In the clinical trial we demonstrated that the addition of fetal oxygen monitoring enables the clinician to allow labor to progress when it is safe to do so," he said in a statement. "We have gained an important level of security and confidence that we are making clinical decisions based on the right information."
Without a direct way to determine the oxygen saturation of an unborn baby, the only choice for the medical staff was to intervene on behalf of the child when it showed signs of distress.
Those measures included providing the mother with supplemental oxygen, physically stimulating the baby, taking a fetal blood sample or delivering the child with forceps, a vacuum extractor or by Caesarean.
Sometimes the fetal heart rate can slow or become "non-reassuring" simply because the baby has fallen asleep inside the womb.
Other times, it can signal a dangerous lack of oxygen, but the fetal heart monitor cannot distinguish the difference.
"Our current fetal heart monitoring technology, which has been around for 30 years, provides exceptional sensitivity but little specificity," Dilde said. "It can identify tiny changes in the fetal heart rate but cannot specify the underlying cause of those changes.
"Fetal oxygen monitoring, in conjunction with fetal heart rate monitoring, provides a more complete picture and will have a dramatic impact on the practice of obstetrics."
E-mail: haddoc@desnews.com