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    Aiming to Avoid the Scalpel

    The Unkindest Cut


    "It gives more information and objective information so we can say, 'This baby needs to come out and needs to come out in an emergency fashion,' or 'This baby can tolerate labor a little longer and perhaps have a vaginal birth,'" says Simpson, a co-investigator in the multicenter study on fetal oxygen monitors.

    In the past, medical teams have used fetal scalp blood sampling to determine fetal oxygen levels, but Simpson tells WebMD the process of obtaining the blood from the baby's scalp is invasive, and often must be repeated several times.

    The fetal oxygen monitor, on the other hand, usually causes no more discomfort than a traditional vaginal exam, Simpson says. A disposable sensor connected to a cable is inserted through the birth canal after rupture of the amniotic membranes ("breaking of water"), and rests against the baby's cheek, temple, or forehead, pressing up against the uterine wall. Using red and infrared light, the sensor analyzes the fetus' blood oxygen level, and this information is displayed on a monitor, providing real-time data to the OB team.

    The normal oxygen saturation for a fetus is usually between 30% and 70%, Simpson says. A lack of oxygen for an extended period of time can result in hypoxia, brain damage, or even death.

    With the oxygen monitor, Schuler was able to avoid the scalpel and vaginally deliver a healthy baby girl.

    "It was kind of scary, because in five minutes they had me numbed up and the operating room ready to go," Schuler says. "But it turned out the baby was fine, which was great because no one wants to get a C-section if you don't have to."

    The percentage of C-sections recently has been rising after a steady decline from 1989 to 1995. About 22% of live births in 1999 were delivered by C-section, a 4% increase from 1998, the CDC reports. What's more, the rehospitalization rate after C-sections was 80% compared to the 30% of those rehospitalized following an uncomplicated vaginal birth. In general, women who undergo C-sections risk infections of the uterus or around the incision, as well as urinary and gallbladder complications.

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