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胎儿脉搏血氧饱和度测定的可靠性:胎儿氧饱和度低于30%对围产期结局的影响。

The reliability of fetal pulse oximetry: the effect of fetal oxygen saturation below 30% on perinatal outcome.

作者信息

Csitári István Kis, Pasztuhov Agoston, László Adám

机构信息

Department of Obstetrics and Gynecology, Szent Lázár County Hospital, Salgótarján, Hungary.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2008 Feb;136(2):160-4. doi: 10.1016/j.ejogrb.2007.02.021. Epub 2007 Apr 30.

Abstract

OBJECTIVES

The objective of this prospective study was to determine the reliability of fetal pulse oximetry (FPO) in cases of abnormal fetal heart rate (FHR) pattern and fetal oxygen saturation (FSpO(2)) below 30%.

STUDY DESIGN

Three hundred and one deliveries complicated by abnormal FHR pattern were monitored with both CTG and FPO. Cases of FSpO(2) values below 30% (n=52) formed the study group and those above 30% (n=249) were the control group. pH and base excess (BE) in the umbilical cord artery, 5-min Apgar score, and pH and BE in the newborn were measured and compared. Statistical analysis included the Epi info 2002 program, Chi-squared test, and linear regression.

RESULTS

FSpO(2) values were consequently below 30% in 52 and above 30% in 249 cases. When FSpO(2) values were below 30%, umbilical pH was significantly lower than in controls (P<0.01), while other parameters were not significantly different. If the time interval between the measurement of the first low (<30%) FSpO(2) value and delivery did not exceed 32.4+/-2.5 min, umbilical pH and Apgar scores did not show fetal acidosis.

CONCLUSION

Our findings suggest that FPO is a reliable method of estimating fetal condition and may help reduce the number of cesarean sections performed due to abnormal FHR tracings.

摘要

目的

本前瞻性研究的目的是确定在胎儿心率(FHR)模式异常且胎儿氧饱和度(FSpO₂)低于30%的情况下胎儿脉搏血氧饱和度测定(FPO)的可靠性。

研究设计

对301例并发FHR模式异常的分娩进行了CTG和FPO监测。FSpO₂值低于30%的病例(n = 52)组成研究组,高于30%的病例(n = 249)为对照组。测量并比较脐动脉的pH值和碱剩余(BE)、5分钟Apgar评分以及新生儿的pH值和BE。统计分析包括Epi info 2002程序、卡方检验和线性回归。

结果

因此,52例FSpO₂值低于30%,249例高于30%。当FSpO₂值低于30%时,脐动脉pH值显著低于对照组(P<0.01),而其他参数无显著差异。如果首次测得低(<30%)FSpO₂值与分娩之间的时间间隔不超过32.4±2.5分钟,脐动脉pH值和Apgar评分未显示胎儿酸中毒。

结论

我们的研究结果表明,FPO是评估胎儿状况的可靠方法,可能有助于减少因FHR异常而进行剖宫产的次数。

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