Luzietti R, Erkkola R, Hasbargen U, Mattsson L A, Thoulon J M, Rosén K G
Department of Obstetrics and Gynecology, University of Parma, Italy.
J Perinat Med. 1999;27(6):431-40. doi: 10.1515/JPM.1999.058.
This report form part of the European Community Multi-Center Trial "Fetal ECG Analysis during Labor". Aim of this prospective trial was to identify changes in the fetal ECG waveform with cases of verified fetal hypoxia. In this paper we also report on the use of a newly developed automatic system for identification of ST waveform changes (ST Log). All ECG were recorded with the STAN recorder (Neoventa Medical AB, Gothenburg, Sweden). The ECG information was not displayed during labor in order not to influence the clinical management. This report includes data from 320 cases and include six cases of fetal intrapartum hypoxia. Twenty seven cases showed changes in ST waveform. All five cases with the most marked ST change (a rise in T/QRS of > 0.10 units and lasting more then 10 minutes) had signs of ongoing intrapartum hypoxia. Six out of six cases with evidence of intrapartum asphyxia, showed ST changes. On the basis of our multi-center trial it appears that the combined analysis of CTG and ST waveform changes provides an accurate way to identify adverse events during labor. The work is continuing with a new STAN recorder developed by Neoventa Medical in Göteborg and currently being tested in a Swedish randomized, controlled multi-center trial.
本报告是欧洲共同体多中心试验“分娩期间胎儿心电图分析”的一部分。这项前瞻性试验的目的是确定已证实胎儿缺氧病例中胎儿心电图波形的变化。在本文中，我们还报告了一种新开发的用于识别ST波形变化的自动系统（ST Log）的使用情况。所有心电图均使用STAN记录仪（瑞典哥德堡的Neoventa Medical AB公司）记录。分娩期间未显示心电图信息，以免影响临床管理。本报告包括320例病例的数据，其中包括6例胎儿产时缺氧病例。27例显示ST波形变化。所有5例ST变化最明显（T/QRS升高>0.10单位且持续超过10分钟）的病例均有产时持续缺氧的迹象。6例有产时窒息证据的病例中有6例显示ST变化。根据我们的多中心试验，似乎CTG和ST波形变化的联合分析为识别分娩期间的不良事件提供了一种准确的方法。使用哥德堡的Neoventa Medical公司开发的新型STAN记录仪的工作正在继续，目前正在瑞典的一项随机对照多中心试验中进行测试。
