Near-infrared spectroscopy for fetal assessment during labour

Background Over the past four decades, continuous electronic fetal monitoring (EFM) has been increasingly employed to detect fetal acidaemia in labour, with a view toward prevention of hypoxic ischaemic encephalopathy, permanent neurologic injury, and death. Although very sensitive, this technology has low specificity, and a high false positive rate. This false positive rate has resulted in operative intervention on behalf of many fetuses who were not in fact in danger of neurologic injury or death. Near-infrared spectroscopy has been developed to directly measure fetal cerebral oxygenation, with a view toward identification of those fetuses truly at risk. Objectives Objectives To determine the effects of the use of near-infrared spectroscopy to assess fetal condition during labour, on maternal and perinatal outcomes. Search methods Search methods We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (August 2009). Selection criteria Selection criteria Randomised trials comparing near-infrared spectroscopy with continuous EFM alone or continuous EFM and scalp pH. Data collection and analysis Data collection and analysis No trials were identified. If they had been, both authors would have assessed eligibility and trial quality. Main results Main results No randomised trials were identified. Thus no studies were included. Authors' conclusions Authors' conclusions There is currently insufficient evidence to assess the efficacy of fetal surveillance by near-infrared spectroscopy.