Trochez Ruben D, Sibanda Thabani, Sharma Rohit, Draycott Tim
Department of Obstetrics & Gynaecology, Southmead Hospital, Bristol, UK.
J Matern Fetal Neonatal Med. 2005 Nov;18(5):349-52. doi: 10.1080/14767050500261770.
To investigate whether accelerations of the fetal heart rate in response to scalp stimulation (the scalp stimulation test) before fetal scalp blood sampling (FBS) are such a good predictor of fetal well-being as to render the FBS unnecessary.
A retrospective observational study. Cardiotocograms (CTG) from 54 fetuses during labor in whom 70 FBS procedures were performed, were analysed by an investigator blinded to the outcome, to determine whether accelerations were present in response to fetal scalp stimulation during vaginal examination (VE) prior to the FBS. This was compared with the pH obtained at FBS in a 2 x 2 table. The primary outcome measure was the false negative rate of the scalp stimulation test.
There were accelerations at 48 VEs before FBS (n = 70). In five cases there was fetal acidosis (pH<or=7.20). Three of these five fetuses had accelerations at VE, giving a false negative rate of 6.25%.
These data do not support previous reports that accelerations in response to fetal scalp stimulation before FBS exclude fetal acidosis when the CTG is suspicious and FBS is otherwise indicated. A larger sample may help answer this question.
研究在胎儿头皮血采样（FBS）前，胎儿心率对头皮刺激的加速反应（头皮刺激试验）是否是胎儿健康状况的良好预测指标，以至于无需进行FBS。
一项回顾性观察研究。由对结果不知情的研究者分析54例分娩胎儿的70次FBS操作期间的胎心监护图（CTG），以确定在FBS前阴道检查（VE）期间胎儿头皮刺激时是否存在加速反应。将其与FBS时获得的pH值在2×2表格中进行比较。主要结局指标是头皮刺激试验的假阴性率。
在70次FBS前的48次VE中有加速反应。5例存在胎儿酸中毒（pH≤7.20）。这5例胎儿中有3例在VE时有加速反应，假阴性率为6.25%。
这些数据不支持先前的报告，即在CTG可疑且其他情况下需要进行FBS时，FBS前胎儿头皮刺激的加速反应可排除胎儿酸中毒。更大的样本量可能有助于回答这个问题。
