Validation of a Novel Transabdominal Fetal Oximeter in a Hypoxic Fetal Lamb Model
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ORIGINAL ARTICLE
Validation of a Novel Transabdominal Fetal Oximeter in a Hypoxic Fetal Lamb Model Daniel D. Fong 1 & Kaeli J. Yamashiro 2 & Michael Austin Johnson 3,4 & Kourosh Vali 1 & Laura A. Galganski 2 & Christopher D. Pivetti 2 & Diana L. Farmer 2 & Herman L. Hedriana 5 & Soheil Ghiasi 1 Received: 24 February 2020 / Accepted: 6 May 2020 # Society for Reproductive Investigation 2020
Abstract Current intrapartum fetal oxygen saturation (SaO2) monitoring methodologies are limited, mostly consisting of fetal heart rate monitoring which is a poor predictor of fetal hypoxia. A newly developed transabdominal fetal oximeter (TFO) may be able to determine fetal SaO2 non-invasively. This study is to validate a novel TFO in determining fetal SaO2 in a hypoxic fetal lamb model. Fetal hypoxia was induced in at-term pregnant ewe by placing an aortic occlusion balloon infrarenally and inflating it in a stepwise fashion to decrease blood flow to the uterine artery. The inflation was held at each step for 10 min, and fetal arterial blood gases (ABGs) were intermittently recorded from the fetal carotid artery. The balloon catheter was deflated when fetal SaO2 fell below 15%, and the fetus was recovered. A total of three desaturation experiments were performed. The average fetal SpO2 reported by the TFO was derived at each hypoxic level and correlated with the ABG measures. Fetal SaO2 from the ABGs ranged from 10.5 to 66%. The TFO SpO2 correlated with the ABG fetal SaO2 (r-squared = 0.856) with no significant differences (p > 0.5). The fetal SpO2 measurements from TFO were significantly different than the maternal SpO2 (p < 0.01), which suggests that the transcutaneous measurements are penetrating through the maternal abdomen sufficiently and are expressing the underlying fetal tissue physiology. The recently developed TFO system was able to non-invasively report the fetal SpO2, which showed strong correlation with ABG measures and showed no significant differences. Keywords Fetal pulse oximetry . Hypoxic fetal lamb . Noninvasive . Oxygen saturation . Pregnant ewe . Aortic occlusion
Introduction Currently, intrapartum assessment of fetal well-being is primarily accomplished through fetal heart rate monitoring, which performs real-time continuous assessment of the fetal heart rate (FHR) and displayed on either paper or digital * Daniel D. Fong [email protected] 1
Electrical and Computer Engineering, University of California Davis, Davis, CA, USA
2
Department of Surgery, University of California Davis Health, Sacramento, CA, USA
3
Department of Emergency Medicine, University of California Davis Health, Sacramento, CA, USA
4
Present address: Division of Emergency Medicine, Department of Surgery, University of Utah, Salt Lake City, UT, USA
5
Department of Obstetrics and Gynecology, University of California Davis Health, Sacramento, CA, USA
imagery. It is thought that fetal bradycardia after a contraction may be indicative of fetal asphyxia, and that surgical intervention could be needed [1]. Since the introduction of
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