Kawagoe Yasuyuki, Sameshima Hiroshi, Ikenoue Tsuyomu
Department of Obstetrics and Gynecology and Perinatal Center, Faculty of Medicine, University of Miyazaki, Japan.
Reprod Sci. 2008 Jul;15(6):567-71. doi: 10.1177/1933719107308144.
The authors show that pulse transit time and blood pressure are reciprocal in fetal goat models. They applied this technique in clinical settings to correlate changes in pulse transit time with fetal heart rate monitoring patterns and acid-base status. In 18 uncomplicated pregnancies, pulse transit time was obtained from electrocardiograms to pulse oximeter waveform and averaged during each baseline period, defined by the interpretation of fetal heart rate monitoring. According to a > 10% change from the control value, chronological changes were categorized into shortened, unchanged, and prolonged. Pulse transit time was available in 82% +/- 11% of the recordings. In 15 fetuses, 2 (13%) showed prolonged, 7 (47%) showed shortened, and 6 (40%) showed unchanged conditions. Comparisons of the shortened and unchanged categories revealed that severe variable deceleration was significantly increased, and half or more fetuses showed hypoxemia in the shortened category. Shortening of pulse transit time, theoretically indicating a hypertensive condition, was more frequently associated with severe variable decelerations, suggesting that the pulse transit time may supplement the interpretation of fetal heart rate monitoring.
作者表明，在胎羊模型中，脉搏传输时间与血压呈反比关系。他们将这项技术应用于临床，以关联脉搏传输时间的变化与胎儿心率监测模式及酸碱状态。在18例无并发症的妊娠中，从心电图到脉搏血氧仪波形获取脉搏传输时间，并在每个由胎儿心率监测解读定义的基线期进行平均。根据与对照值相差>10%的变化，将时间变化分为缩短、不变和延长三类。82%±11%的记录可获取脉搏传输时间。在15例胎儿中，2例（13%）显示延长，7例（47%）显示缩短，6例（40%）显示无变化。缩短组与无变化组的比较显示，重度变异减速显著增加，且缩短组中半数或更多胎儿出现低氧血症。脉搏传输时间缩短理论上表明存在高血压状况，更常与重度变异减速相关，提示脉搏传输时间可能补充胎儿心率监测的解读。
