Aiming to Avoid the Scalpel
The Unkindest Cut
Of the 6,800 babies born annually at St. John's, about 23% are
delivered by C-section. Simpson says she is hopeful that the oxygen monitor
will reduce that.
A clinical study of more than 1,000 births at nine sites
nationwide suggested that fetal oxygen monitors, when used in conjunction with
heart rate monitors, could halve the number of C-sections related to a
"nonreassuring" heart rate. But the study, published in the November
2000 issue of the American Journal of Obstetrics and Gynecology, also
found an increase in the overall number of cesarean deliveries due to dystocia
-- failure of the baby to pass through the pelvis. The company that makes the
monitors and which funded the study, St. Louis-based Mallinckrodt Inc., is
paying for further research to determine what effect the monitors might be
having, if any, on women who encounter such difficulties. "It's a very
puzzling finding from the study," says Garite, a co-author of the study.
"We are doing a follow-up, multicenter study to look at the
Researchers also are examining whether the oxygen monitors
could be useful in evaluating premature infants, Garite says. Currently, the
monitor is employed only in women dilated past two centimeters whose water has
broken after a fetal heart monitor shows an abnormal rate. Women who are
carrying more than one fetus, who are less than 36 weeks pregnant, or who are
carrying a breech baby cannot use the device.
Mallinckrodt declined to disclose the number of hospitals using
OxiFirst, but says more and more are adopting the system. At the time of FDA
approval, the fetal oxygen monitor had been relied on in more than 35,000
births. The technology has been available in Europe since 1996 and in Canada
Garite says he envisions every hospital eventually making use
of the technology, which could improve what he considers the often overly
intense circumstances under which babies are born.
"We are unnecessarily scaring our moms," Garite says.
"When they see us looking at the [heart rate] monitor and becoming
concerned and putting oxygen on their faces, they put two and two together.
That kind of unnecessary intervention increases the whole anxiety level. As
people begin to realize with this monitor that actual hypoxia is so much less
frequent, the whole environment will improve."
Kimberly Sanchez is a freelance writer in St. Louis and a
frequent contributor to WebMD. She also has written for the Los Angeles
Times, New York Newsday, the Chicago Sun-Times, and the Dallas Morning