Schiermeier S, Hatzmann H, Reinhard J
Frauenklinik der Universität Witten/Herdecke, Marien-Hospital, Witten.
Z Geburtshilfe Neonatol. 2009 Feb;213(1):6-10. doi: 10.1055/s-0028-1112147. Epub 2009 Mar 3.
The low specificity, together with the high intra- and interobserver variability, of cardiotocography (CTG) necessitates the use of additive fetal assessment methods. The German Society of Obstetrics and Gynaecology (DGGG) advises the use of computerised CTG analysis software systems. In this study we have examined the use of computerised CTG analysis together with the fetal pulse oximetry.
Using the "CTG-Online ((R))" software five consecutive deliveries were simultaneously analysed by the FIGO score and the saturation rate of fetal pulse oximetry. All CTGs were classified as pathological and at least one fetal scalp pH measurement was carried out. Fetal outcome and results of the fetal scalp pH values were evaluated against the fetal pulse oximetry rates.
Signal loss was low at less than 5%. No fetus showed a hypoxic state. Only 0.98% of the fetal pulse oximetry saturation rates were below 30% oxygen saturation. No fetus showed an oxygen saturation of below 35% for 10 min duration or more.
Fetal pulse oximetry saturation rates can be another helpful marker for fetal well-being in a modern labour ward. Further studies are required to verify whether fetal pulse oximetry saturation rates can improve the specificity of CTG for fetal acidosis.
宫缩图(CTG)特异性低,且观察者内和观察者间的变异性高,因此需要使用辅助胎儿评估方法。德国妇产科学会(DGGG)建议使用计算机化CTG分析软件系统。在本研究中,我们研究了计算机化CTG分析与胎儿脉搏血氧饱和度测定法的联合应用。
使用“CTG-Online ((R))”软件,通过FIGO评分和胎儿脉搏血氧饱和度测定法的饱和度对连续5例分娩进行同步分析。所有CTG均被分类为病理性,并且至少进行了一次胎儿头皮pH值测量。根据胎儿脉搏血氧饱和度测定率评估胎儿结局和胎儿头皮pH值结果。
信号丢失率低,低于5%。没有胎儿出现缺氧状态。只有0.98%的胎儿脉搏血氧饱和度测定率低于30%的氧饱和度。没有胎儿出现氧饱和度低于35%且持续10分钟或更长时间的情况。
在现代产房,胎儿脉搏血氧饱和度测定率可以作为评估胎儿健康状况的另一个有用指标。需要进一步研究以验证胎儿脉搏血氧饱和度测定率是否可以提高CTG对胎儿酸中毒的特异性。