Department of Obstetrics, Charité - Universitätsmedizin Berlin, Berlin, Germany.
J Perinat Med. 2010;38(1):83-6. doi: 10.1515/jpm.2010.006.
To determine the predictive value of fetal pulse oximetry (FPO) for the development of fetal acidosis in cases of non-reassuring fetal heart rate (FHR).
In a prospective observational study, pulse oximetry monitoring was examined in cases of non-reassuring FHR during singleton cephalic delivery at 36-42 weeks' gestation. The study examined whether fetal arterial oxygen saturation (FSpO(2)) values <30% for at least 10 min during the last 60 min before delivery increase the risk of fetal acidosis. The predictive reliability of this algorithm and the correlation to fetal acidosis [umbilical artery pH (UApH) <7.15] were analyzed.
We included 101 patients with non-reassuring FHR during delivery. The incidence of fetal acidosis was significantly higher when FSpO(2) values <30% were recorded for at least 10 min (P=0.0). An UApH <7.15 was reliably excluded with a negative predictive value of 98.7% and detected with a sensitivity of 92.9%.
A low pulse oximetry oxygen saturation <30% for at least 10 min correlates highly with fetal acidosis in cases of non-reassuring FHR. FPO reliably excludes moderate to advanced acidosis and can reduce the frequency of fetal blood analysis (FBA) in cases of non-reassuring cardiotocography (CTG).
确定胎儿脉搏血氧饱和度（FPO）在非反应性胎心监护（FHR）情况下预测胎儿酸中毒的价值。
在一项前瞻性观察性研究中，在 36-42 周妊娠的单胎头位分娩中，对非反应性 FHR 进行脉搏血氧监测。该研究检查了在分娩前最后 60 分钟内，胎儿动脉血氧饱和度（FSpO2）值<30%且持续至少 10 分钟是否会增加胎儿酸中毒的风险。分析了该算法的预测可靠性及其与胎儿酸中毒（脐动脉 pH 值<7.15）的相关性。
我们纳入了 101 例分娩时非反应性 FHR 的患者。当记录到 FSpO2 值<30%且持续至少 10 分钟时，胎儿酸中毒的发生率显著更高（P=0.0）。阴性预测值为 98.7%，灵敏度为 92.9%，可靠地排除了 UApH<7.15。
在非反应性 FHR 的情况下，低脉搏血氧饱和度<30%且持续至少 10 分钟与胎儿酸中毒高度相关。FPO 可靠地排除了中度至重度酸中毒，并可以减少非反应性胎心监护（CTG）情况下胎儿血液分析（FBA）的频率。
