Current Innovative Methods of Fetal pH Monitoring-A Brief Review

Diagnostics (Basel). 2022 Nov 3;12(11):2675. doi: 10.3390/diagnostics12112675.

Abstract

In this study, we explore the "why?", and "how?", monitoring the pH of the fetal scalp is used, and show its limitations. In addition, we review the development of new devices based on the modern physics and nanomaterials serving this topic. Most of the works we found in our search have focused on improving the prognostic of fetal heart rate monitoring, because it is the "golden standard" in determining fetal distress. Although the best-known screening method, it can only provide limited information about the actual status of the fetus. The best predictive assessment, with the highest reproducibility, states that a normal fetal heart rate is indicative of a healthy baby. However, its excellent sensitivity is much reduced when identifying the actual "distress". This is when second-line monitoring methods come into play to guide the diagnostics and direct the obstetrician towards an action plan. Although a historic method, fetal scalp pH sampling is still under review as to its efficiency and place in the current obstetrics. Continuous surveillance of the fetal parameters is important, especially for the fetuses undergoing intrauterine growth restricted (IUGR). Since fetal scalp blood sampling is still under research and is a randomized controlled trial, which compares the relevance of pH and lactates to the obstetrical situation, the maternal-fetal medicine could greatly benefit from the introduction of engineered nanomedicines to the field.

Keywords: cardiotocografic monitoring; electrochemical sensors; fetal and neonatal monitoring; fetal scalp pH sampling; materno-fetal; pH; spectral monitoring of oxygen saturation; ultrasound monitoring.

Publication types

  • Review

Grants and funding

A.M. Iordache was supported by a grant of the Romanian Ministry of Education and Research, CNCS—UEFISCDI, project number PN-III-P1-1.1-PD-2019-1134 (Ctr. No. PD87/2020), S.M. Iordache and C.E.A. Grigorescu were supported by grants of the Romanian Ministry of Education and Research, CNCS—UEFISCDI, project number PN-III-P2-2.1-PED-2019-2551 (Ctr. No. 393PED/2020), CORE Program, Ctr. 18/N/2019 within PNCDI III and by the Ministry of Research and Innovation through Program I—Development of the National R&D System, Subprogram 1.2—Institutional Performance—Projects for Excellence Financing in RDI, contract no. 18PFE/30.12.2021).