Su Lin-Lin, Chong Yap-Seng, Biswas Arijit
Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Ann Acad Med Singap. 2007 Jun;36(6):416-20.
Intrapartum fetal monitoring is essential for the identification of fetal hypoxia to reduce perinatal morbidity and mortality. Cardiotocography is associated with low specificity for fetal acidosis and poor perinatal outcome leading to unnecessary operative deliveries. ST waveform analysis of the fetal electrocardiogram has been shown to be a promising adjunctive intrapartum assessment tool. We aim to present the pathophysiology, the role of intrapartum monitoring and the practical usage of this relatively new technology in our review.
An electronic search of Medline and OVID was carried out, followed by a manual search of the references identified by the electronic search.
The incorporation of ST waveform analysis to cardiotocography has been shown to reduce the rates of neonatal metabolic acidosis, moderate and severe neonatal encephalopathy, thus improving perinatal outcome. The reduction in operative delivery rates due to fetal distress is also significant. The pathophysiology and practical usage of this technology were discussed.
With more accurate identification of fetal hypoxia and reduction of unnecessary intervention rates, incorporation of ST waveform analysis of fetal electrocardiography into cardiotocography can improve the standard of intrapartum fetal monitoring.
产时胎儿监测对于识别胎儿缺氧以降低围产期发病率和死亡率至关重要。胎心监护对胎儿酸中毒的特异性较低，且围产期结局不佳，导致不必要的手术分娩。胎儿心电图的ST段波形分析已被证明是一种有前景的产时辅助评估工具。我们旨在在本综述中阐述其病理生理学、产时监测的作用以及这项相对新技术的实际应用。
对Medline和OVID进行电子检索，随后对电子检索所识别的参考文献进行手工检索。
将ST段波形分析纳入胎心监护已被证明可降低新生儿代谢性酸中毒、中度和重度新生儿脑病的发生率，从而改善围产期结局。因胎儿窘迫导致的手术分娩率的降低也很显著。讨论了该技术的病理生理学和实际应用。
通过更准确地识别胎儿缺氧并降低不必要的干预率，将胎儿心电图的ST段波形分析纳入胎心监护可提高产时胎儿监测的标准。
