Monitoring of antepartum and intrapartum fetal hypoxemia: Pathophysiological basis and available techniques

The challenge of obstetric surveillance is to identify those fetuses whose physiological defence mechanisms are compromised, in order to be able to ac t before decompensation has occurred. During the antenatal period, the eval uation of fetal hemodynamic adaptation to hypoxemia and the assessment of i ts chronological evolution by Doppler technology are crucial. During the in trapartum period, the relative inaccessibility of the fetus and the complex ity of the pathophysiology of fetal oxygenation make it difficult to obtain and interpret information on the fetal response to labor stress. Due to th e limitations of cardiotocography, additional information is required for a ppropriate decision making during labor. Current evidence suggests that mod ern technology applied to fetal surveillance can provide useful additional information that can improve our capacity to interpret fetal reactions to l abor events. Copyright (C) 2001 S. Karger AG. Basel.