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Alternative Names Return to topFetal scalp blood; Scalp pH testing; Fetal blood testing - scalp
Definition Return to top
Fetal scalp pH testing is a vaginal procedure performed when a woman is in active labor to determine if the baby is getting enough oxygen.
How the Test is Performed Return to top
The procedure typically takes about 5 minutes. The mother lies on her back with her feet in stirrups. If her cervix is dilated at least 3 to 4 centimeters, a plastic cone is placed in the vagina and fit snuggly against the scalp of the fetus.
The scalp of the fetus is cleansed and pierced, and a small blood sample is taken for examination. The blood is collected in a thin tube. The tube is either sent to the hospital laboratory or analyzed by a machine in the labor and delivery department. In either case, results are available in just a few minutes.
If the woman's cervix is not dilated enough, it is impossible to perform this test.
How to Prepare for the Test Return to top
The health care provider will explain the procedure and its risks. There isn't always a separate consent form for this procedure because many hospitals consider it part of the general consent form you signed at admission.
How the Test Will Feel Return to top
The procedure should feel like a long pelvic exam. At this stage of labor, many patients already have had epidural anesthesia and may not feel the pressure of the procedure at all.
Why the Test is Performed Return to top
Usually this test is performed to obtain information about fetal acid-base balance (blood pH). Sometimes fetal heart monitoring doesn't provide enough information about the well-being of a baby. In these cases, testing the scalp pH can help the doctor decide whether the fetus is getting enough oxygen during labor. This helps determine whether the baby is healthy enough to continue labor, or if a forceps delivery or cesarean section might be the best route of delivery.
Although the test is not uncommon, most deliveries do not involve fetal scalp pH testing.
Normal Results Return to top
Normal fetal blood sample results are:
What Abnormal Results Mean Return to top
A fetal scalp blood pH level less than 7.20 is considered abnormal.
In general, low pH suggests that the baby does not have enough oxygen, which could mean that the baby is not tolerating labor very well. However, the results of a fetal scalp pH sample need to be interpreted in the context of each individual labor. The provider may feel that the results indicate that the baby needs to be delivered quickly, either by forceps or by cesarean section.
Fetal scalp pH testing may need to be repeated a few times during a complicated labor to continue to check on the baby.
Risks Return to top
Risks include the following:
Considerations Return to top
This test is not recommended for mothers with infections, such as HIV or Hepatitis C.
References Return to top
Garite TJ. Intrapartum Fetal Evaluation. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics – Normal and Problem Pregnancies. 5th ed. New York, NY: Churchill Livingstone; 2007:chap 15.Update Date: 7/27/2008 Updated by: Jennifer K. Mannheim, CRNP, private practice, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.