Barton D P, Turner M J, Boylan P C, MacDonald D, Stronge J M
National Maternity Hospital, Dublin, Ireland.
Eur J Obstet Gynecol Reprod Biol. 1991 Apr 16;39(2):93-8. doi: 10.1016/0028-2243(91)90070-2.
The effect of parity on intrapartum fetal scalp pH was investigated in 6466 patients in labour with a live fetus who were delivered in 1987. 350 (5.4%) required fetal scalp blood sampling for pH (FBS), 236 primigravidae (10.4%) and 114 multigravidae (2.7%) (P less than 0.001). Fetal acidosis (pH less than 7.20) was detected in 35 patients, 27 primigravidae (11.4%) and 8 multigravidae (7.0%) (P less than 0.001). The incidence of intrapartum acidosis in the 2275 primigravidae and the 4191 multigravidae was 1.2 and 0.2% respectively (P less than 0.001). The two deaths from birth asphyxia and three cases of neonatal seizures occurred in primigravidae. In primigravidae requiring FBS, fetal acidosis was not associated with the use of oxytocin or with increased duration of labour. Neonatal seizures were more common overall in primigravidae than in multigravidae and more common in patients requiring FBS than in those not requiring FBS (P less than 0.05). The higher incidence of FBS, fetal scalp acidosis and neonatal seizures in primigravidae has important implications for intrapartum fetal monitoring.
1987年对6466例分娩活产胎儿的产妇进行了产次对产时胎儿头皮pH值影响的研究。350例（5.4%）需要进行胎儿头皮血pH值采样（FBS），其中初产妇236例（10.4%），经产妇114例（2.7%）（P<0.001）。35例检测到胎儿酸中毒（pH<7.20），其中初产妇27例（11.4%），经产妇8例（7.0%）（P<0.001）。2275例初产妇和4191例经产妇的产时酸中毒发生率分别为1.2%和0.2%（P<0.001）。2例出生窒息死亡和3例新生儿惊厥发生在初产妇中。在需要FBS的初产妇中，胎儿酸中毒与使用缩宫素或产程延长无关。总体而言，初产妇的新生儿惊厥比经产妇更常见，需要FBS的患者比不需要FBS的患者更常见（P<0.05）。初产妇中FBS、胎儿头皮酸中毒和新生儿惊厥的较高发生率对产时胎儿监测具有重要意义。
