Fetal monitoring with pulse oximetry

Article Abstract:

Pulse oximetry is an inexpensive, noninvasive method of measuring heart rate and arterial oxygen saturation (a comparison between the amount of oxygen in a sample of blood with the amount that could be present); its use has brought dramatic changes in patient monitoring. The method was evaluated for fetal monitoring during labor and delivery. Two studies were carried out: one used pulse oximetry on fetuses during 86 deliveries, and the other used the method before and after the induction of labor in 40 women. In the first study, all fetuses were delivered in good condition, and oximetry values for these uncomplicated deliveries are presented. Average oximetry readings in later stages of labor were lower those than in early labor, indicating a fall in oxygen saturation. In the second study, the membranes surrounding the fetus were ruptured, but prior to this, oximetric recordings were possible through the intact membranes. Oxygen saturation did not appear to change after membrane rupture. Disadvantages of other methods of fetal monitoring (heart rate evaluation, and blood sampling) are cited, and the merits of recording oxygen saturation versus recording partial pressure (the amount of dissolved gas) are discussed. Technical aspects of the oximeter are explained. Although the approach has limitations, particularly those due to fetal presentation (position and movement through the birth canal), it can be applied in obstetrics to help detect fetal complications. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Usage, Measurement, Oxygen, Fetal heart rate monitoring, Electronic fetal monitoring, Oxygen in the body, Oximetry

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The vanishing bowel. Case report of bowel atresia following gastroschisis

Article Abstract:

This article describes the case report of a 20-year-old woman who gave birth to a baby with congenital intestinal atresia (closure of the intestine). The woman had no family history of congenital disease, did not drink or smoke, and did not use illegal drugs. At week 17 of gestation an ultrasound examination showed sections of bowel floating in the amniotic fluid, outside of the fetal abdominal cavity. A second ultrasound scan was performed four weeks later and a diagnosis of congenital gastroschisis (a fissure that remains open in the abdomen wall) was made. There were no other abnormalities. The rest of the pregnancy was uneventful and at week 38 of gestation, following 20 hours of labor, the woman gave birth to a 7 pound baby boy who appeared to be in good condition with no obvious abnormalities. However, nine hours after birth the baby began to vomit green bile. When abdominal X-rays were taken and surgery was performed, it was observed that the entire small intestine was missing. Since there was not enough intestine present for the baby to live and no surgical techniques are currently available to correct this situation, the baby and mother were both discharged; the infant died four days after birth at home. This case illustrates that a vascular accident occurring during the second trimester of pregnancy can cause intestinal atresia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Abnormalities, Causes of, Fetus, Birth defects, Intestines, Pregnancy, Complications of, Pregnancy complications

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Photosensitization of the endometrium with topical 5-aminolevulinic acid

Article Abstract:

Photosensitizing the endometrium with protoporphyrin IX could help surgeons selectively destroy only the endometrium when using photodynamic therapy in women with menorrhagia. Current procedures destroy tissue indiscriminately. Researchers irrigated four uteruses removed during hysterectomy with 5-aminolevulinic acid, which is the precursor of protoporphyrin IX. They did the same in eight women who were scheduled to have a hysterectomy. Following the operation, uterine tissue samples were tested for the presence of protoporphyrin IX. Levels of the fluorescent chemical were 9 to 10 times higher in the endometrium, or outer layer, than in the myometrium, which is the middle layer of the uterus. Fluorescence microscopy revealed the presence of protoporphyrin IX in the endometrium but not in the myometrium.

Evaluation, Endometrium, Photosensitization, Biological, Biological photosensitization

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