Huddleston J F
Department of Obstetrics and Gynecology, University of Florida Health Science Center at Jacksonville, Florida, USA.
Clin Perinatol. 1999 Sep;26(3):549-68, v.
Some of the difficulty in assessing the clinical value of intrapartum fetal-heart-rate (FHR) monitoring stems from lack of uniformity in pattern interpretation and, therefore, in response to perceived FHR abnormalities. This article reviews the physiology and pathophysiology of FHR changes, stresses the new NICHD guidelines for unambiguously defining FHR patterns, emphasizes the avoidance of circumstances stressful to the fetus, and suggests appropriate treatment for the distressed fetus. The strong likelihood that such treatment will be successful in reversing abnormal FHR patterns, as well as the importance of preparing for expedient delivery should such treatment fail, are noted. Finally, some of the newer tools for judging the timing of perinatal brain injury are described.
评估产时胎儿心率（FHR）监测临床价值存在一定困难，部分原因在于模式解读缺乏一致性，进而导致对所察觉到的FHR异常的应对缺乏一致性。本文回顾了FHR变化的生理学和病理生理学，强调了美国国立儿童健康与人类发展研究所（NICHD）明确界定FHR模式的新指南，着重指出应避免对胎儿造成压力的情况，并提出了针对窘迫胎儿的适当治疗方法。文中指出，此类治疗很有可能成功逆转异常FHR模式，同时也强调了若治疗失败，为迅速分娩做好准备的重要性。最后，介绍了一些用于判断围产期脑损伤时机的更新工具。
