Repérage de l’asphyxie au cours du travail

摘要

Intrapartum asphyxia is defined as metabolic acidemia measured at birth with pH < 7.00 and base deficit ≥ 12 mmol/L. It is today established that the proportion of cerebral palsy associated with intrapartum hypoxia-ischemia is about 14.5%. Intrapartum asphyxia is screened in France by the continuous fetal heart rate (FHR) monitoring which presents a good sensitivity for its detection. His low specificity justifies the use of second line methods to reduce the increase of cesarean deliveries associated with the use of continuous FHR monitoring. Fetal scalp pH and lactate measurements are still the reference method. The conclusions of the last meta-analysis on the RCTs of the use of the fetal electrocardiogram (STAN®) appear to be disappointing, because no differences were found in the rates of metabolic acidosis and the rates of cesarean deliveries. Intrapartum asphyxia’s diagnostic can be made by analysis of the acidbase status on the cord arterial blood. Therefore, it should be systematically performed after every births.