Reine Kopfsache: Fetal Scalp Stimulation zur Bestimmung der fetalen Vitalität während der Geburt

Um die vitalen Ressourcen des Ungeborenen während der Geburt zu bestimmen, kommt häufig die Mikroblutuntersuchung zum Einsatz. Die sogenannte Fetal Scalp Stimulation kann als Zusatzkriterium oder in ressourcenarmen Settings als Alternative eingesetzt werden. Eine Bachelorarbeit zeigt aktuelle Evidenzen und internationale Leitlinien zur Fetal Scalp Stimulation auf und gibt Handlungsempfehlungen für die Praxis.

Publication History

Article published online:
01 March 2023

• Literatur

• 1 Abou-Dakn M, Schäfers R, Peterwerth N. et al. Vaginale Geburt am Termin (2020). AWMF 015/083. Im Internet: https://www.awmf.org/uploads/tx_szleitlinien/015-083m_S3_Vaginale-Geburt-am-Termin_2021-01_1.pdf; Stand: 13.12.2022
• 2 ACOG. Practice Bulletin Clinical Management Guidelines for Obstetrician – Intrapartum Fetal Heart Rate Monitoring: Nomenclature, Interpretation, and General Management Principles Obstetrics Gynecology. 2009. 114. 192-202
• 3 Arulkumaran S, Ingemarsson I, Ratnam SS. Fetal Heart Rate Response to Scalp Stimulation as a Test of Fetal Well-Being in Labour. Asia- Oceania Journal of Obstetrics Gynaecology 1987; 13: 131-132
• 4 Carbonne B, Pons K, Maisonneuve E. Foetal scalp blood sampling during labour for pH and lactate measurements. Best Practice and Research: Clinical Obstetrics and Gynaecology 2015; 30: 62-67
• 5 Clark SL, Gimovsky ML, Miller FC. Fetal heart rate response to scalp blood sampling. American Journal of Obstetrics and Gynecology 1982; 144: 706-708
• 6 Clark SL, Gimovsky ML, Miller FC. The scalp stimulation test: A clinical alternative to fetal scalp blood sampling. American Journal of Obstetrics and Gynecology 1984; 148: 274-277
• 7 Deutsches Netzwerk Evidenzbasierte Medizin e.V. EBM – Basics – Methodik (2022). Im Internet: https://www.ebm-netzwerk.de/de/service-ressourcen/ebm-basics/methodik; Stand: 13.12.2022
• 8 Gilbert M, Ghesquiere L, Drumez E. et al. How to reduce fetal scalp blood sampling? A retrospective study evaluating the diagnostic value of scalp stimulation to predict fetal wellbeing assessed by scalp blood sampling. European Journal of Obstetrics and Gynecology and Reproductive Biology 2021; 263: 153-158
• 9 Goodman DM, Mlay P, Thielman N. et al. Using fetal scalp stimulation with Doppler ultrasonography to enhance intermittent auscultation in low-resource settings: A diagnostic trial from Tanzania. BMC Pregnancy and Childbirth 2019; 19: 71
• 10 Gruber P, Oehler-Rahman K, Schwarz C. CTG- verstehen, bewerten, dokumentieren. In: Schwarz C, Stahl K, Hrsg. Evidenz & Praxis. 7. Aufl. Hannover: Elwin Staude; 2020
• 11 Holzmann M, Wretler S, Nordström L. Absence of accelerations during labor is of little value in interpreting fetal heart rate patterns. Acta Obstetricia et Gynecologica Scandinavica 2016; 95: 1097-1103
• 12 Howick J, Chalmers I, Glasziou P. et al. The Oxford 2011 Levels of Evidence (Table). Oxford Centre for Evidence-Based Medicine. Im Internet: http://www.cebm.net/index.aspx?o=5653; Stand: 13.12.2022
• 13 Hughes O, Murphy DJ. Comparing second-line tests to assess fetal wellbeing in Labor: a feasibility study and pilot randomized controlled trial. Journal of Maternal-Fetal and Neonatal Medicine 2020; 35: 91-99
• 14 Murphy DJ, Devane D, Molloy E. Fetal scalp stimulation for assessing fetal wellbeing during labour. Cochrane Database of Systematic Reviews 2020; 12
• 15 National Institute for Health and Care Excellence (NICE). Intrapartum care for healthy women and babies. National Institute for Health and Care Excellence 2017: 33–54
• 16 Nordhausen T, Hirt J, Gallen FH. Manual zur Literaturrecherche in Fachdatenbanken. St. Gallen: Martin-Luther-Universität Halle-Wittenberg FHS 2018; 1-325
• 17 Pinas A, Chandraharan E. Continuous cardiotocography during labour: Analysis, classification and management. Best Practice and Research: Clinical Obstetrics and Gynaecology 2016; 30: 33-47
• 18 Rathore AM, Ramji S, Devi CB. Fetal scalp stimulation test: An adjunct to intermittent auscultation in non-reassuring fetal status during labor. Journal of Obstetrics and Gynaecology Research 2011; 37: 819-824
• 19 Shakouri F, Iorizzo L, Edwards HMK. et al. Effectiveness of fetal scalp stimulation test in assessing fetal wellbeing during labor, a retrospective cohort study. BMC Pregnancy and Childbirth 2020; 20: 1-7
• 20 Shea BJ, Reeves BC, Wells G. et al. AMSTAR 2: A critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ (Online) 2017; 358: 1-9
• 21 Skupski DW, Rosenberg CR, Eglinton GS. Intrapartum fetal stimulation tests: A meta-analysis. Obstetrics and Gynecology 2002; 99: 129-134
• 22 Tahir Mahmood U, O’Gorman C, Marchocki Z. et al. Fetal scalp stimulation (FSS) versus fetal blood sampling (FBS) for women with abnormal fetal heart rate monitoring in labor: a prospective cohort study. Journal of Maternal-Fetal and Neonatal Medicine 2018; 31: 1742-1747
• 23 Tahmina S, Daniel M, Krishnan L. Manual fetal stimulation during intrapartum fetal surveillance: a randomized controlled trial. American Journal of Obstetrics and Gynecology MFM 2022; 4: 1-6
• 24 Vetter K. Mikroblutuntersuchung – Es geht auch ohne. Deutsche Hebammenzeitschrift 2019; 71: 40-45
• 25 Visser GH, Ayres-De-Campos D. FIGO consensus guidelines on intrapartum fetal monitoring: Adjunctive technologies. International Journal of Gynecology and Obstetrics 2015; 131: 25-29