Bassel H. Al Wattar
Evaluating the value of intrapartum fetal scalp blood sampling to predict adverse neonatal outcomes: A UK multicentre observational study.
Al Wattar, Bassel H.; Lakhiani, Aarti; Sacco, Adalina; Siddharth, Aditi; Bain, Alexandra; Calvia, Alexandra; Kamran, Atiyah; Tiong, Bing; Warwick, Bethan; MacMahon, Caroline; Marcus, Diana; Long, Emma; Coyle, Gillian; Elizabeth Lever, Gillian; Michel, Gina; Gopal, Gomathy; Baig, Hana; Louise Price, Hannah; Badri, Hawra; Stevenson, Helen; Hoyte, Helene; Malik, Humaira; Edwards, Jade; Hartley, Jennifer; Hemers, Jennifer; Tamblyn, Jennifer; Dalton, John Alexander William; Frost, Jonathan; Subba, Kamana; Baxter, Kathryn; Sivakumar, Kavitha; Murphy, Kelly; Papadakis, Konstantinos; Bladon, Laura Rachel; Kasaven, Lorraine; Manning, Louisa; Prior, Mathew; Ghosh, Mausumi; Couch, Melanie; Altunel, Melis; Pearce, Melissa; Cocker, Michael; Stephanou, Michael; Jie, Michelle; Mistry, Minesh; Wahby, Mohammed Osama; Saidi, Nabila Shahid; Ramshaw, Nicola Louise; Tempest, Nicola; Parker, Nina; Tan, Phoebe L; Johnson, Racheal Louise; Harris, Rachel; Tildesley, Rachel; Ram, Ramya; Painuly, Ritu; Cuffolo,...
Authors
Aarti Lakhiani
Adalina Sacco
Aditi Siddharth
Alexandra Bain
Alexandra Calvia
Atiyah Kamran
Bing Tiong
Bethan Warwick
Caroline MacMahon
Diana Marcus
Emma Long
Gillian Coyle
Gillian Elizabeth Lever
Gina Michel
Gomathy Gopal
Hana Baig
Hannah Louise Price
Hawra Badri
Helen Stevenson
Helene Hoyte
Humaira Malik
Jade Edwards
Jennifer Hartley
Jennifer Hemers
Jennifer Tamblyn
John Alexander William Dalton
Jonathan Frost
Kamana Subba
Kathryn Baxter
Kavitha Sivakumar
Kelly Murphy
Konstantinos Papadakis
Laura Rachel Bladon
Lorraine Kasaven
Louisa Manning
Mathew Prior
Mausumi Ghosh
Melanie Couch
Melis Altunel
Melissa Pearce
Michael Cocker
Michael Stephanou
Michelle Jie
Minesh Mistry
Mohammed Osama Wahby
Nabila Shahid Saidi
Nicola Louise Ramshaw
Nicola Tempest
Nina Parker
Phoebe L Tan
Racheal Louise Johnson
Rachel Harris
Rachel Tildesley
Ramya Ram
Ritu Painuly
Romana Cuffolo
Roberta Bugeja
Rose Ngadze
Rosie Grainger
Sabitra Gurung
Sammy Mak
Sara Farrell
Sarah Cowey
Sarah Neary
Sarah Quinn
Simrit Kaur Nijjar
Sophie Kenyon
Stephanie Lamb
Susan Tracey
Tara Lee
Therese Kinsella
Trecia Davidson
Trent Corr
Uzo Sampson
Victoria McQueen
Professor William Parry-Smith w.r.parry-smith@keele.ac.uk
Zora Castling
AB-FAB study group
Abstract
Objective
To evaluate the value of fetal scalp blood sampling (FBS) as an adjunct test to cardiotocography, to predict adverse neonatal outcomes.
Study design
A multicentre service evaluation observational study in forty-four maternity units in the UK. We collected data retrospectively on pregnant women with singleton pregnancy who received FBS in labour using a standardised data collection tool. The primary outcome was prediction of neonatal acidaemia diagnosed as umbilical cord arterial pH < 7.05, the secondary outcomes were the prediction of Apgar scores<7 at 1st and 5th minutes and admission to the neonatal intensive care unit (NICU). We evaluated the correlation between the last FBS blood gas before birth and the umbilical cord blood and adjusted for time intervals. We constructed 2 × 2 tables to calculate the sensitivity, specificity, positive (PPV) and negative predictive value (NPV) and generated receiver operating curves to report on the Area Under the Curve (AUC).
Results
In total, 1422 samples were included in the analysis; pH values showed no correlation (r = 0.001, p = 0.9) in samples obtained within an hour (n = 314), or within half an hour from birth (n = 115) (r=-0.003, p = 0.9). A suboptimal FBS pH value (<7.25) had a poor sensitivity (22%) and PPV (4.9%) to predict neonatal acidaemia with high specificity (87.3%) and NPV (97.4%). Similar performance was noted to predict Apgar scores <7 at 1st (sensitivity 14.5%, specificity 87.5%, PPV 23.4%, NPV 79.6%) and 5th minute (sensitivity 20.3%, specificity 87.4%, PPV 7.6%, NPV 95.6%), and admission to NICU (sensitivity 20.3%, specificity 87.5%, PPV 13.3%, NPV 92.1%). The AUC for FBS pH to predict neonatal acidaemia was 0.59 (95%CI 0.59–0.68, p = 0.3) with similar performance to predict Apgar scores<7 at 1st minute (AUC 0.55, 95%CI 0.51–0.59, p = 0.004), 5th minute (AUC 0.55, 95%CI 0.48–0.62, p = 0.13), and admission to NICU (AUC 0.58, 95%CI 0.52–0.64, p = 0.002).
Forty-one neonates had acidaemia (2.8%, 41/1422) at birth. There was no significant correlation in pH values between the FBS and the umbilical cord blood in this subgroup adjusted for sampling time intervals (r = 0.03, p = 0.83).
Conclusions
As an adjunct tool to cardiotocography, FBS offered limited value to predict neonatal acidaemia, low Apgar Scores and admission to NICU.
Citation
Al Wattar, B. H., Lakhiani, A., Sacco, A., Siddharth, A., Bain, A., Calvia, A., …study group, A. (2019). Evaluating the value of intrapartum fetal scalp blood sampling to predict adverse neonatal outcomes: A UK multicentre observational study. European Journal of Obstetrics and Gynecology and Reproductive Biology, 240, 62-67. https://doi.org/10.1016/j.ejogrb.2019.06.012
Journal Article Type | Article |
---|---|
Acceptance Date | Jun 11, 2019 |
Online Publication Date | Jun 15, 2019 |
Publication Date | 2019-09 |
Deposit Date | Apr 23, 2024 |
Journal | European journal of obstetrics, gynecology, and reproductive biology |
Print ISSN | 0301-2115 |
Publisher | Elsevier |
Peer Reviewed | Peer Reviewed |
Volume | 240 |
Pages | 62-67 |
DOI | https://doi.org/10.1016/j.ejogrb.2019.06.012 |
Public URL | https://keele-repository.worktribe.com/output/773558 |
PMID | 31229725 |
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