Department of Obstetrics and Gynecology, Faculty of Medicine, University of Porto, S. João Hospital, INEB Instituto de Engenharia Biomédica, Porto, Portugal.
Curr Opin Obstet Gynecol. 2010 Apr;22(2):104-9. doi: 10.1097/GCO.0b013e328337233c.
To analyse the reasons why foetal heart rate (FHR) monitoring failed to fulfil the initial expectations of unequivocally decreasing perinatal morbidity and mortality, and to summarize the most recent advances in this field.
It is now clear that expectations towards FHR monitoring at the time of its introduction into clinical practice were unrealistic. Several pitfalls in FHR monitoring have been identified, and solutions established to avoid them. Correct use of FHR equipment and adequate tracing recording are as important as analysis and interpretation. New methods of computerized FHR analysis have been developed, and wide clinical validation of these is currently ongoing. More concrete guidelines on future research and development, as well as on regular training of healthcare professionals have been produced.
FHR monitoring needs to be used with realistic expectations. Acquisition, storage and analysis of tracings according to available guidelines need to be guaranteed. Integration of data with foetal blood sampling and foetal ECG analysis during labour, and with umbilical artery blood flow analysis or the biophysical profile in the antepartum period, may further improve clinical decisions. Central monitoring stations and computer analysis are becoming more widespread and are currently undergoing wide clinical evaluation. Research, development and training need to take into account recent guidelines outlining the main issues in these fields.
分析胎儿心率（FHR）监测未能如最初预期般明确降低围产儿发病率和死亡率的原因，并总结该领域的最新进展。
现在很明显，在 FHR 监测引入临床实践时的预期是不切实际的。已经确定了 FHR 监测中的几个陷阱，并制定了避免这些陷阱的解决方案。正确使用 FHR 设备和适当的描记记录与分析和解释同样重要。已经开发出用于计算机化 FHR 分析的新方法，目前正在广泛进行临床验证。已经制定了关于未来研究和开发以及医疗保健专业人员定期培训的更具体指南。
FHR 监测需要基于现实的预期。必须保证根据现有指南获取、存储和分析迹线。在分娩期间将数据与胎儿血液采样和胎儿心电图分析、以及在产前期间与脐动脉血流分析或生物物理概况进行整合，可能会进一步改善临床决策。中央监测站和计算机分析正在变得更加普及，目前正在进行广泛的临床评估。研究、开发和培训需要考虑到最近的指南，这些指南概述了这些领域的主要问题。
