Foetal Monitoring Technologies for the Detection of Intrapartum Hypoxia - Challenges and Opportunities.

Intrapartum foetal hypoxia is related to long-term morbidity and mortality of the foetus and the mother. Foetal surveillance is extremely important to minimize the adverse outcomes arising from foetal hypoxia during labour. Several methods have been used in current clinical practice to monitor foetal well-being. For instance, biophysical technologies including cardiotocography, ST-analysis adjunct to cardiotocography, and Doppler ultrasound are used for intrapartum foetal monitoring. However, these technologies result in a high false-positive rate and increased obstetric interventions during labour. Alternatively, biochemical-based technologies including foetal scalp blood sampling and foetal pulse oximetry are used to identify metabolic acidosis and oxygen deprivation resulting from foetal hypoxia. These technologies neither improve clinical outcomes nor reduce unnecessary interventions during labour. Also, there is a need to link the physiological changes during foetal hypoxia to foetal monitoring technologies. The objective of this article is to assess the clinical background of foetal hypoxia and to review existing monitoring technologies for the detection and monitoring of foetal hypoxia. A comprehensive review has been made to predict foetal hypoxia using computational and machine-learning algorithms. The detection of more specific biomarkers or new sensing technologies is also reviewed which may help in the enhancement of the reliability of continuous foetal monitoring and may result in the accurate detection of intrapartum foetal hypoxia.