Tekin Arzu, Ozkan Sebiha, Calişkan Eray, Ozeren Semih, Corakçi Aydin, Yücesoy Izzet
Kocaeli University, School of Medicine, Department of Obstetrics and Gynecology, Kocaeli, Turkey.
J Obstet Gynaecol Res. 2008 Oct;34(5):824-31. doi: 10.1111/j.1447-0756.2008.00850.x.
To determine how fetal pulse oximetry behaves in various cardiotocographic (CTG) tracings and correlates with neonatal outcome.
Pregnant women undergoing active labor with singleton pregnancies of 32-42 weeks were enrolled. CTG recordings were reassuring or nonreassuring (namely variable or persisting late decelerations). Pulse oximetry values during labor and changing throughout deceleration and recovery phases, duration and frequency of pulse oximetry recordings <30%, and neonatal outcome were determined. One-way anova, Tukey test, chi(2)-test and multiple logistic regression model were used for statistical analysis where appropriate.
A total of 156 pregnant subjects were divided into three groups: reassuring fetal heart rate (FHR) patterns (group 1, n=78 [50%]), late decelerations (group 2, n=16 [10.3%]) and variable decelerations (group 3, n=62 [39.7%]). The initial and final pulse oximetry readings, pulse values in first stage of labor, the duration and the frequency of pulse oximetry recordings <30% were significantly different between groups (P<0.001, P<0.001, P<0.001, P=0.001, P<0.001). Fetal acidosis was significantly more frequent with late decelerations (23.1%, P=0.004). A multiple logistic regression model demonstrated that the initial pulse oximetry value during active labor was the most predictive variable of neonatal well-being (P<0.001).
Decreased fetal pulse oximetry values, especially prolonged and recurrent recordings <30% are well-correlated with abnormal FHR patterns, indicating an association with fetal compromise and metabolic acidosis. Going through active labor with a lower initial value of FSpO(2) more frequently leads to an altered FHR pattern and subsequent adverse fetal outcome.
确定胎儿脉搏血氧饱和度在各种胎心监护（CTG）描记图中的表现及其与新生儿结局的相关性。
纳入孕周为32 - 42周、单胎妊娠且处于活跃期分娩的孕妇。CTG记录结果分为正常或异常（即变异或持续晚期减速）。测定分娩期间及减速和恢复阶段脉搏血氧饱和度值的变化、脉搏血氧饱和度记录<30%的持续时间和频率以及新生儿结局。在适当情况下，采用单因素方差分析、Tukey检验、卡方检验和多元逻辑回归模型进行统计分析。
共156名孕妇被分为三组：胎心监护（FHR）模式正常组（第1组，n = 78 [50%]）、晚期减速组（第2组，n = 16 [10.3%]）和变异减速组（第3组，n = 62 [39.7%]）。三组间初始和最终脉搏血氧饱和度读数、第一产程中的脉搏值、脉搏血氧饱和度记录<30%的持续时间和频率存在显著差异（P<0.001、P<0.001、P<0.001、P = 0.001、P<0.001）。晚期减速时胎儿酸中毒明显更常见（23.1%，P = 0.004）。多元逻辑回归模型表明，活跃期分娩时的初始脉搏血氧饱和度值是新生儿健康状况的最具预测性的变量（P<0.001）。
胎儿脉搏血氧饱和度值降低，尤其是持续时间延长和反复记录<30%，与异常FHR模式密切相关，提示与胎儿窘迫和代谢性酸中毒有关。分娩活跃期初始FSpO₂值较低更常导致FHR模式改变及随后的不良胎儿结局。
