Bekedam D J, Mulder E J, Snijders R J, Visser G H
Department of Obstetrics and Gynaecology, University Hospital Groningen, The Netherlands.
Early Hum Dev. 1991 Dec;27(3):223-32. doi: 10.1016/0378-3782(91)90196-a.
In hypoxemic intrauterine growth-retarded fetuses (IUGR) there is a reduction in the incidence of fetal movements and in fetal heart rate variation. A causal relationship with the impairment of fetal oxygenation has been suggested. In 16 IUGR fetuses and in 13 normally grown fetuses maternal hyperoxygenation was applied for 40 min to increase fetal PO2 levels. All IUGR fetuses had abnormal Doppler blood velocity waveforms of the umbilical artery suggesting an impaired uteroplacental exchange. The effect of hyperoxygenation on fetal breathing and body movements and on fetal heart rate was evaluated. In the IUGR fetuses there was a significant increase in fetal breathing and body movements and in heart rate variation during hyperoxygenation as compared to the preceding control period of 40 min. No significant changes in fetal breathing and body movements were found in the normally grown control fetuses. A surprising observation was the increase of the number of heart rate decelerations after discontinuation of the maternal hyperoxygenation. It is concluded that in IUGR fetuses the increase in fetal heart rate variation and the increase in the incidence of breathing and body movements during maternal hyperoxygenation substantiates the relationship between these variables and the oxygenation status of the fetus.
在低氧血症性宫内生长受限胎儿（IUGR）中，胎动发生率和胎儿心率变异性降低。有人提出这与胎儿氧合受损存在因果关系。对16例IUGR胎儿和13例正常生长胎儿的母亲进行了40分钟的高氧治疗，以提高胎儿的PO2水平。所有IUGR胎儿的脐动脉多普勒血流速度波形均异常，提示子宫胎盘交换受损。评估了高氧对胎儿呼吸、身体运动和胎儿心率的影响。与之前40分钟的对照期相比，IUGR胎儿在高氧治疗期间胎儿呼吸、身体运动以及心率变异性显著增加。在正常生长的对照胎儿中未发现胎儿呼吸和身体运动有显著变化。一个惊人的发现是母亲高氧治疗停止后心率减速次数增加。结论是，在IUGR胎儿中，母亲高氧治疗期间胎儿心率变异性增加以及呼吸和身体运动发生率增加，证实了这些变量与胎儿氧合状态之间的关系。
