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胎儿心率下降区域及其与分娩期间胎儿和母亲酸碱指标的关系。

Dip area in fetal heart rate and its relationship to acid-base-observations of fetus and mother during labor.

作者信息

Künzel W, Cornely M

出版信息

J Perinat Med. 1976;4(4):271-9. doi: 10.1515/jpme.1976.4.4.271.

Abstract

The relationship between dip area (DA) of fetal heart rate (FHR) and the acid base status of fetus and mother during the first and second stage of labor were studied on 39 women at term. The observations reveal a significant correlation between the fall in fetal base excess (BE) and the measured DA: deltaBE = 0.01 - 0.143 DA (2alpha less than 0.01). There is no difference in the correlation of these parameters between the first and the second stage of labor despite the fact of a greater fall in BE and a greater DA per time compared to the first:BE meq/1/10min. 0.14 (SD 0.26) and 0.76 (SD 0.62); DA cm2/10 min. 0.99 (SD 1.19) and 4.28 (SD 3.06), respectively. With increasing DA the variance of the fall of fetal BE (S2BE) rose also: DA of 0-5 cm2: S2BE 0.66; DA greater than 15.1cm2:S2BE 3.76. With the fall in fetal BE there was also a fall in maternal BE, more pronounced during the second stage of labor:-BEF=0.38.DELTA BEM-0.70(2alphaless than 0.01). The fraction of the fall in fetal BE per DA increased with the fall in maternal BE (2alpha less than 0.05). This correlation reveals that there might be a slight influence of maternal BE on fetal BE. The present observation shows that measuring DA serves only as an approach to predict fetal condition during labor. It therefore should be combined with fetal scalp blood sampling. The influence of maternal BE on fetal BE seems to be only of less importance.

摘要

对39名足月孕妇在分娩第一和第二阶段胎儿心率(FHR)的下降面积(DA)与胎儿及母亲酸碱状态之间的关系进行了研究。观察结果显示胎儿碱剩余(BE)下降与测量的DA之间存在显著相关性:ΔBE = 0.01 - 0.143 DA(2α<0.01)。尽管与第一阶段相比,第二阶段BE下降幅度更大且每次DA更大:BE(meq/1/10min)分别为0.14(标准差0.26)和0.76(标准差0.62);DA(cm2/10min)分别为0.99(标准差1.19)和4.28(标准差3.06),但在分娩第一和第二阶段这些参数的相关性并无差异。随着DA增加,胎儿BE下降的方差(S2BE)也上升:DA为0 - 5 cm2时:S2BE为0.66;DA大于15.1 cm2时:S2BE为3.76。随着胎儿BE下降,母亲BE也下降,在分娩第二阶段更明显:-BEF = 0.38·ΔBEM - 0.70(2α<0.01)。胎儿BE每DA下降的比例随母亲BE下降而增加(2α<0.05)。这种相关性表明母亲BE可能对胎儿BE有轻微影响。目前的观察表明,测量DA仅作为预测分娩期间胎儿状况的一种方法。因此,它应与胎儿头皮血采样相结合。母亲BE对胎儿BE的影响似乎不太重要。

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