Nikolov A, Dimitrov A, Vakrilova L, Iarŭkova N, Tsankova M, Krŭsteva K
Akush Ginekol (Sofiia). 2005;44(1):24-31.
The objective of this study is to establish the reference values range of the fetal oxygen saturation during the first and the second period of labor and their dispersal according to the extent of cervical dillatation in cases with normal FHR--absence of fetal hypoxia and asphyxia of the newborn.
This is a prospective study which involves 94 women with normal FHR. All of the newborns are with umbilical artery pH values greater than 7.15 and 5 min Apgar score greater than 7; there was no necessity for any reanimation procedures, assisted ventilation or intensive care treatment. The fetal oxygen saturation (SpO2) is monitored by fetal pulseoxymeter Nellcor N 400, fetal sensors FS - 14. Cardiotocographic monitoring is carried out simultaneously. Blood is obtained from the fetal scalp during labor for blood gas and pH analysis, and umbilical artery pH as well as the Apgar score of the newborn are determined.
The average monitoring time during the first period of labor is 107.19+/-29.49 min. with reliability of the recordings 86.54+/-6.10%. The average monitoring time for the second period of labor is 36.72+/-8.31 min. with reliability of the recordings 75.42 +/-9.61%. The mean SpO2 values are 48.71+/-5.52% during the first period and 47.30+/-4.62% during the second period of labor. The reference SpO2 values ranging between the 25-th and 75-th percentile in fetuses with normal FHR are 46-52 % for the first and 44-50 % for the second period. The results for fetal SpO2 during the different stages of cervical dillatation are as follows: for 4-5 cm - 49.49+/-5.12%, for 6-7 cm - 48.76+/-5.42%, for 8-9 cm - 48.39+/-5.49%.
The fetal SpO2 dispersal during cervical dillatation of 4-5, 6-7 and 8-9cm accordingly demonstrates a nonsignificant decrease of SpO2 for the different groups (p>0.05). The fetal SpO2 dispersal between the first and the second period of labor also demonstrates decrease of SpO2 values and shows a minor statistically significant difference (p < 0.05 - Repeated measures ANOVA), which is considered to be within the normal range and does not reflect on the newborn's well-being.
本研究的目的是确定第一产程和第二产程期间胎儿血氧饱和度的参考值范围，以及在胎儿心率正常（无胎儿缺氧和新生儿窒息）的情况下，根据宫颈扩张程度的血氧饱和度离散度。
这是一项前瞻性研究，涉及94例胎儿心率正常的女性。所有新生儿脐动脉pH值均大于7.15，5分钟Apgar评分大于7；无需任何复苏程序、辅助通气或重症监护治疗。使用Nellcor N 400胎儿脉搏血氧仪和FS - 14胎儿传感器监测胎儿血氧饱和度（SpO2）。同时进行胎心监护。在分娩期间从胎儿头皮取血进行血气和pH分析，并测定新生儿脐动脉pH值和Apgar评分。
第一产程的平均监测时间为107.19±29.49分钟，记录可靠性为86.54±6.10%。第二产程的平均监测时间为36.72±8.31分钟，记录可靠性为75.42±9.61%。第一产程期间平均SpO2值为48.71±5.52%，第二产程期间为47.30±4.62%。胎儿心率正常的胎儿中，第25至第75百分位数之间的参考SpO2值，第一产程为46 - 52%，第二产程为44 - 50%。宫颈扩张不同阶段的胎儿SpO2结果如下：4 - 5厘米时为49.49±5.12%，6 - 7厘米时为48.76±5.42%，8 - 9厘米时为48.39±5.49%。
在宫颈扩张4 - 5厘米、6 - 7厘米和8 - 9厘米时，不同组的胎儿SpO2离散度显示SpO2无显著下降（p>0.05）。第一产程和第二产程之间的胎儿SpO2离散度也显示SpO2值下降，且有轻微统计学显著差异（p < 0.05 - 重复测量方差分析），这被认为在正常范围内，且不反映新生儿的健康状况。
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