Sherer David M, Dalloul Mudar, Pierre Nadia, Abulafia Ovadia
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, State University of New York, Downstate Medical Center, Brooklyn, New York 11203, USA.
Am J Perinatol. 2005 Apr;22(3):165-7. doi: 10.1055/s-2005-864852.
Uterine contraction-associated accelerations of the maternal heart rate are considered to reflect both a transient contraction-related increase in cardiac output and endogenous catecholamine secretion. Uterine contraction-associated decelerations of the maternal heart rate are rare and remain unexplained. A young multiparous patient with systemic lupus erythematosus (postrenal transplant for lupus nephropathy-related renal failure) presented in early labor at 39 weeks gestation, prior to elective repeat cesarean section. Intrapartum continuous maternal heart rate monitoring demonstrated repetitive uterine contraction associated decelerations of the maternal heart rate of 60 beats per minute, each lasting 2 minutes, simulating nonreassuring fetal status. Simultaneously depicted fetal heart rate was reassuring. This case demonstrates an unusual marked early intrapartum affect of uterine contractions upon the maternal heart rate. In addition, this case illustrates the potentially dangerous similarity of an intrapartum maternal heart rate to an abnormal fetal heart rate pattern, and emphasizes the importance of correct identification of the maternal and fetal heart rates, respectively.
与子宫收缩相关的母体心率加速被认为既反映了与收缩相关的心输出量短暂增加，也反映了内源性儿茶酚胺分泌。与子宫收缩相关的母体心率减速很少见，原因不明。一名年轻的经产妇，患有系统性红斑狼疮（因狼疮性肾病相关肾衰竭接受肾移植），在妊娠39周早期分娩，计划择期再次剖宫产。产时持续监测母体心率显示，与子宫收缩相关的母体心率反复减速，每分钟60次，每次持续2分钟，模拟胎儿状况不佳。同时显示的胎儿心率正常。该病例表明，子宫收缩在产时早期对母体心率有异常的显著影响。此外，该病例说明了产时母体心率与异常胎儿心率模式潜在的危险相似性，并强调了分别正确识别母体和胎儿心率的重要性。
