{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T13:39:05Z","timestamp":1777037945735,"version":"3.51.4"},"reference-count":18,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,12,7]],"date-time":"2023-12-07T00:00:00Z","timestamp":1701907200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Since the 1970s, fetal scalp blood sampling (FSBS) has been used as a second\u2010line test of the acid\u2013base status of the fetus to evaluate fetal well\u2010being during labor. The commonly employed thresholds that delineate normal pH (&gt;7.25), subnormal (7.20\u20137.25), and pathological pH (&lt;7.20) guide clinical decisions. However, these experienced\u2010based thresholds, based on observations and common sense, have yet to be confirmed. The aim of the study was to investigate if pH drop rate accelerates at the common thresholds (7.25 and 7.20) and to explore the possibility of identifying more accurate thresholds.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>A retrospective study was conducted at a tertiary maternity hospital between June 2017 and July 2021. Patients with at least one FSBS during labor for category II fetal heart rate and delivery of a singleton cephalic infant were included. The rate of change in pH value between consecutive samples for each patient was calculated and plotted as a function of pH value. Linear regression models were used to model the evolution of the pH drop rate estimating slope and standard errors across predefined pH intervals. Exploration of alternative pH action thresholds was conducted. To explore the independence of the association between pH value and pH drop rate, multiple linear regression adjusted on age, body mass index, parity, oxytocin stimulation and suspected small for gestational age was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 2047 patients with at least one FSBS (total FSBS 3467); with 2047 umbilical cord blood pH, and a total of 5514 pH samples. Median pH values were 7.29 1\u2009h before delivery, 7.26 30 min before delivery. The pH drop was slow between 7.40 and 7.30, then became more pronounced, with median rates of 0.0005\u2009units\/min at 7.25 and 0.0013\u2009units\/min at 7.20. Out of the alternative pH thresholds, 7.26 and 7.20 demonstrated the best alignment with our dataset. Multiple linear regression revealed that only pH value was significantly associated to the rate of pH change.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our study confirms the validity and reliability of current guideline thresholds for fetal scalp pH in category II fetal heart rate.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14739","type":"journal-article","created":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T02:20:54Z","timestamp":1702002054000},"page":"479-487","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Re\u2010evaluating fetal scalp <scp>pH<\/scp> thresholds: An examination of fetal <scp>pH<\/scp> variations during labor"],"prefix":"10.1111","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6101-1200","authenticated-orcid":false,"given":"Aude","family":"Girault","sequence":"first","affiliation":[{"name":"Center of Research in Epidemiology and StatisticS\/CRESS\/Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOP\u00e9), INSERM U 1153 Universit\u00e9 Paris Cit\u00e9  Paris France"},{"name":"Cochin Hospital, Assistance Publique\u2010H\u00f4pitaux de Paris, Universit\u00e9 Paris Cit\u00e9 Port Royal Maternity Unit  Paris France"},{"name":"Laboratoire d'Informatique M\u00e9dicale et d'Ing\u00e9nierie des Connaissances pour la e\u2010Sant\u00e9, LIMICS Sorbonne Universit\u00e9, Inserm, Universit\u00e9 Sorbonne Paris\u2010Nord  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camille","family":"Le\u00a0Ray","sequence":"additional","affiliation":[{"name":"Center of Research in Epidemiology and StatisticS\/CRESS\/Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOP\u00e9), INSERM U 1153 Universit\u00e9 Paris Cit\u00e9  Paris France"},{"name":"Cochin Hospital, Assistance Publique\u2010H\u00f4pitaux de Paris, Universit\u00e9 Paris Cit\u00e9 Port Royal Maternity Unit  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Garabedian","sequence":"additional","affiliation":[{"name":"Department of obstetrics, Univ. Lille, ULR 2694\u2014Metrics CHU Lille  Lille France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fran\u00e7ois","family":"Goffinet","sequence":"additional","affiliation":[{"name":"Center of Research in Epidemiology and StatisticS\/CRESS\/Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOP\u00e9), INSERM U 1153 Universit\u00e9 Paris Cit\u00e9  Paris France"},{"name":"Cochin Hospital, Assistance Publique\u2010H\u00f4pitaux de Paris, Universit\u00e9 Paris Cit\u00e9 Port Royal Maternity Unit  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xavier","family":"Tannier","sequence":"additional","affiliation":[{"name":"Laboratoire d'Informatique M\u00e9dicale et d'Ing\u00e9nierie des Connaissances pour la e\u2010Sant\u00e9, LIMICS Sorbonne Universit\u00e9, Inserm, Universit\u00e9 Sorbonne Paris\u2010Nord  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,12,7]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2022.07.001"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.12421"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181aef106"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogc.2019.05.007"},{"key":"e_1_2_11_6_1","unstructured":"YoungC RyceA.Fetal Scalp Lactate Testing During Intrapartum Pregnancy with Abnormal Fetal Heart Rate: A Review of Clinical Effectiveness Cost\u2010Effectiveness and Guidelines [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2018 Mar 26. Table\u00a07 Summary of Included Evidence\u2010Based Guidelines.https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK532205\/table\/app4.tab2\/"},{"key":"e_1_2_11_7_1","unstructured":"Government of Wester Australia North Metropolitan Health Service Women and Newborn Health Service.Clinical Practice Guideline \u2010 Fetal scalp blood sampling [Internet].https:\/\/www.kemh.health.wa.gov.au\/~\/media\/HSPs\/NMHS\/Hospitals\/WNHS\/Documents\/Clinical\u2010guidelines\/Obs\u2010Gyn\u2010Guidelines\/Fetal\u2010scalp\u2010blood\u2010sampling.pdf?thn=0"},{"key":"e_1_2_11_8_1","unstructured":"The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.Intrapartum Fetal Surveillance. Clinical Guideline\u2010 Fourth Edition 2019.2022."},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2015.06.021"},{"key":"e_1_2_11_10_1","unstructured":"NICE Guidance.Intrapartum Care for Healthy Women and Babies.2017.https:\/\/www.nice.org.uk\/guidance\/cg190\/resources\/intrapartum\u2010care\u2010for\u2010healthy\u2010women\u2010and\u2010babies\u2010pdf\u201035109866447557"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(67)90515-7"},{"key":"e_1_2_11_12_1","first-page":"262","article-title":"Blood gas relations and the acid\u2010base equilibrium of the fetus in an uncomplicated course of delivery","volume":"161","author":"Saling E","year":"1964","journal-title":"Z Geburtshilfe Gynakol"},{"key":"e_1_2_11_13_1","volume-title":"Das kind im Bereich der Geburtshilfe [the child in the field of obstetrics.]","author":"Saling E","year":"1966"},{"key":"e_1_2_11_14_1","first-page":"1537","article-title":"Micro\u2010hematological studies in fetuses. 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