Question: Should the base excess be used as an independant factor in interpretation of fetal blood sampling results during labour?
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Answer: The NICE guideline on intrapartum care (2007) found there was limited evidence of a correlation between fetal base deficit and longer-term outcomes.
A randomised controlled trial published in 2008 (Wiberg-Itzel) found no significant differences in rate of acidaemia at birth after use of lactate analysis or pH analysis of fetal scalp blood samples to determine hypoxia during labour.
(Evidence level Ib)
References:
- National Institute for Health and Clinical Excellence. Intrapartum care: care of healthy women and their babies during childbirth. London: RCOG Press, 2007.
- Wiberg-Itzel E, Lipponer C, Norman M, Herbst A, Prebensen D, Hansson A, Bryngelsson AL, Christoffersson M, Sennström M, Wennerholm UB, Nordström L. Determination of pH or lactate in fetal scalp blood in management of intrapartum fetal distress: randomised controlled multicentre trial. BMJ. 2008 Jun 7;336(7656):1284-7.
Search date: March 2011
Classification of evidence levels
Ia Evidence obtained from meta-analysis of randomised controlled trials.
Ib Evidence obtained from at least one randomised controlled trial.
IIa Evidence obtained from at least one well-designed controlled study without randomisation.
IIb Evidence obtained from at least one other type of well-designed quasi-experimental study.
III Evidence obtained from well-designed non-experimental descriptive studies, such as comparative studies, correlation studies and case studies.
IV Evidence obtained from expert committee reports or opinions and/or clinical experience of respected authorities.
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