Matsuda Yoshio, Maeda Takatsugu, Kouno Satoshi
Department of Obstetrics and Gynecology, Kagoshima City Hospital, Kagoshima, Japan.
Eur J Obstet Gynecol Reprod Biol. 2003 Jan 10;106(1):36-9. doi: 10.1016/s0301-2115(02)00212-9.
Our purpose was to determine the critical period for non-reassuring fetal heart rate (FHR) patterns in preterm gestation in predicting fetal acidosis (umbilical arterial pH <7.1) at birth.
A prospective descriptive study was performed. We reviewed the FHR pattern and umbilical blood gas level measurements, and investigated the correlations between non-reassuring FHR patterns and umbilical arterial pH.
There was a significant difference in the frequency of fetal acidosis between the neonatal death and survival groups (5/13 versus 30/759, P=0.0001). Umbilical pH values in fetuses with persistent late deceleration with loss of variability (7.15+/-0.11, P<0.01) and in those with prolonged deceleration (7.17+/-0.16, P<0.01) were significantly lower than in fetuses with reassuring FHR patterns (7.29+/-0.06). Fetal acidosis also occurred more often in these two groups. The critical periods for late deceleration with loss of variability and for prolonged deceleration were 60 and 30 min, respectively.
These data indicate that a critical period for non-reassuring FHR patterns in preterm gestation exists. Prompt delivery is required within that short critical period.
我们的目的是确定早产时胎儿心率（FHR）异常模式预测出生时胎儿酸中毒（脐动脉pH<7.1）的关键时期。
进行了一项前瞻性描述性研究。我们回顾了FHR模式和脐血气水平测量结果，并研究了异常FHR模式与脐动脉pH之间的相关性。
新生儿死亡组和存活组胎儿酸中毒的发生率存在显著差异（5/13对30/759，P=0.0001）。伴有变异消失的持续性晚期减速胎儿（7.15±0.11，P<0.01）和伴有延长减速的胎儿（7.17±0.16，P<0.01）的脐pH值显著低于FHR模式正常的胎儿（7.29±0.06）。这两组中胎儿酸中毒的发生率也更高。伴有变异消失的晚期减速和延长减速的关键时期分别为60分钟和30分钟。
这些数据表明早产时存在FHR异常模式的关键时期。在这个短的关键时期内需要及时分娩。
