PLD.27 Fetal Blood Sampling in the Operating Theatre – Advised or Indefensible?

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There is a body of opinion within expert witnesses that suggests that the undertaking of fetal scalp blood sampling (FBS) in a theatre setting prior to performing a perceived difficult instrumental delivery in the presence of a pathological cardiotocograph (CTG) is inappropriate and indefensible. This opinion is based upon the fact that FBS delays delivery. In addition, the adoption of a maternal left-lateral position is not possible.

It was perceived by the author that the practice of FBS in theatre was commonplace and was actively taught by consultants to regional trainees. In order to survey this further, a questionnaire with scenarios was sent out to all registrars and consultants in the region and a total of 60 responses were obtained including 24 consultants. This confirmed the perception that FBS in theatre was commonplace with 33% of respondents stating that this would be their management decision in the first scenario given. 37% of respondents stated that they would undertake FBS in the delivery room prior to transfer to theatre and 27% stated that they would not undertake FBS at all. It is surprising how varied the decision making is given that the scenario proffered is a daily occurrence on the delivery suite. It is also a common scenario that leads to litigation with very large sums of money involved.

This is an important matter that requires clarity from the Royal College of Obstetricians and Gynaecologists (RCOG). It is clear that there are more questions to be asked around this matter.

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