[Should pH scalp blood sampling still be done during labor?].

OBJECTIVES

Determine whether the pH of fetal scalp blood gives a better evaluation of fetal status and whether cesarean section can be avoided in case of abnormal fetal heart rate.

METHOD

For last 100 patients in which the scalp blood was sampled, scalp pH was compared with cord pH, Agpar score at birth and immediate neonatal outcome.

RESULTS

Among the 100 cases, there were 75 vaginal deliveries. There was a good correlation between scalp pH, umbilical artery pH and the 5-min Apgar score. The specificity of scalp pH > or = 7.25 to identify infants with an umbilical artery pH > or = 7.25 and 5-min Apgar score > or = 7 was 98.5 and 90.7% respectively; the corresponding negative predictive values were 70.3 and 96.7%. Immediate neonatal outcome was favorable for all the vaginal deliveries (n = 75) even though fetal heart rate was abnormal. Scalp pH presumably helped avoid unnecessary cesareans in 60 cases as in 15 case delivery occurred within 30 min or less after fetal scalp blood sampling.

CONCLUSION

Scalp blood sampling for determination of pH is questioned and other methods for evaluating fetal status are being examined. But until these methods can be validated, scalp pH provides a means of avoided some unnecessary cesareans in cases where the fetal heart rate is difficult to analyse.