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Effects of Experimental Head Compression on Transcutaneous Scalp Po₂ in Fetal Lambs

Departments of Obstetrics and Gynecology and of Pediatrics, Erasmus University Medical School, Rotterdam, the Netherlands.

Equatorial compression of the fetal head is known to occur during labor; its effect on trancutaneous scalp Po₂ (Ptco₂) was investigated in acute experiments in four fetal lambs. Fetal Ptco₂, and oxygen tension (Pao₂) and flow in a carotid artery were continuously measured. Equatorial head compression was obtained by inflating a cuff around the fetal head. A strong relationship was shown to exist between Ptco₂ and Pao₂ values in the normoxemic and hypoxemic fetus. Stepwise compression of the fetal head resulted in a Ptco₂ of zero at cuff pressures of 40 to 50 mmHg. Laborlike fetal head compression with an intensity of 50 to 70 mmHg and a duration of one minute resulted in a 30 to 60% fall in Ptco₂. Fetal Pao₂ remained stable in all experiments. The present findings indicate that values of Ptco₂ during fetal head compression do not reflect fetal arterial oxygen tension. This questions the reliability of transcutaneous Po₂ monitoring as a method of intrapartum surveillance.