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By: Jerry Wallis Staff
Writer
Arlington Heights Post
Thursday, July 13, 2000 Page 10
Northwest Community
Hospital became the first hospital in the nation to use
a system that monitors the oxygen an infant receives as
it is being born.
Dr. Richard Levy,
president of the medical staff at the Arlington Heights
hospital, said the OxiFirst Fetal Oxygen Monitoring
System allowed him to avoid performing a Caesarean
section, the surgical delivery of the baby through an
incision in the abdomen and uterus.
Levy, a Long Grove
resident who has been on the hospital's staff for 14
years, said he has brought some 2,000 babies into the
world there during that time, and a total of 3,000 over
his entire career.
But one recent delivery
was a little different.
"I had a patient in
my office Thursday, June 15, who was a few days past her
due date," Levy recalled.
When he hooked up
monitors to the expectant mother, he said, "Her
nonstress test was not reassuring to me that the baby
was doing well."
So Levy sent the woman to
the hospital for labor to be induced.
At the same time, he
said, "I knew that we had just obtained this
technology. I wasn't thinking of being the first at our
hospital or in the country, I wanted to try it."
The OxiFirst system,
introduced by Mallinckrodt Inc., allowed Levy to monitor
the fetus's oxygen status during labor and delivery that
evening.
"It's a soft,
pliable monitor that bends around the baby's head"
and makes contact with the cheek or temple, he said.
"It doesn't cause
any kind of trauma or injury to the baby because its
just resting against the skin."
The system works by
capturing and analyzing reflected light to measure
oxygen saturation.
"The expectant
mother at Northwest Community was in labor for about
eight hours" Levy said.
During that time, he
said, "The fetal heart tones were never
reassuring." However, when standard fetal heart
rate monitors, which have been in use for about 30
years, indicate that a baby might be in distress, Levy
said "50% of the time they're wrong."
Because of that, he said,
"Caesarean sections are sometimes performed when
that baby really is tolerating labor just fine."
When Levy faced deciding
June 15 whether fetal stress would overrule the
patient's desire to give birth naturally, the OxiFirst
system provided valuable information about the baby's
condition.
As a result, he said,
"I was able to avoid a Caesarean section".
According to information
from the hospital, the rates for Caesarean sections vary
by region of the country.
In the United States as a
whole, however, the Caesarean delivery rate topped 21
percent during both 1997 and 1998.
Levy said most Caesarean
deliveries are the result of the failure of a pregnancy
to progress, failure of the baby to fit through the
birth canal or breach birth, which is when the baby's
buttocks or feet are coming through first instead of its
head.
"Fetal
distress," he said, "is actually a relatively
small percentage of Caesarean sections."
Only about 5 to 10
percent are performed because of fetal distress, he
said.
With the availability of
the OxiFirst monitoring system, "The total
(Caesarean birth) rate won't be lowered a tremendous
amount," Levy said.
But he said it should be
able to reduce by half the number of those procedures
that are performed because of fetal distress.
When an expectant mother
has a Caesarean section, Levy said, "It is a big
deal".
In addition to being in
the hospital several days and taking some six weeks to
fully recover, mothers who undergo Caesarean sections
face the same risks as they would with other operations
including infection, he said.
It also increases the
likelihood that the women will need another Caesarean
section for any future pregnancy.
It's estimated that 20 to
30 percent of expectant mothers will be able to take
advantage of the OxiFirst monitoring system.
"First of all,
" Levy said, "There's no need to use it in
every situation."
Instead, he said, it only
needs to be used when there is concern about fetal
distress.
There are also certain
medical requirements for the monitor's use.
The baby needs to be in a
head-first position for delivery, Levy said, the
patient's water must have broke and her cervix must be
dilated more than 2 centimeters.
When fetal stress is a
concern and medical conditions are right, Levy said he
would recommend taking advantage of the OxiFirst system.
He also said he expects
that use of the system, which has been available in
Europe since 1996 and Canada since 1998, will become
common in the United States as well.
"And I applaud our
hospital for working to get this technology, " Levy
said.
It's an example, he said,
of how Northwest Community attempts to stay on the
cutting edge of medical care.
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