Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, UT, USA.
Obstet Gynecol. 2011 Oct;118(4):803-8. doi: 10.1097/AOG.0b013e31822f1b50.
To estimate the time spent in each fetal heart rate category during labor and during the last 2 hours before delivery in term singleton pregnancy and to estimate the relationship between the time spent in each category and short-term neonatal outcomes.
This study reviewed fetal heart rate data and newborn outcomes of women in term labor in 10 hospitals over 28 months. Fetal heart rate characteristics were assessed by labor and delivery nurses, and categories were assigned by computer using definitions from the Eunice Kennedy Shriver National Institute of Child Health and Human Development. The duration of time in each category was calculated and correlated with newborn outcome.
Forty-eight thousand four hundred forty-four patients were identified. Considering all of labor, category I was present 77.9% of the time, category II was present 22.1% of the time, and category III was present 0.004% of the time. In the last 2 hours before delivery, category I decreased to 60.9% of the duration, category II increased to 39.1%, and category III increased to 0.006%. Newborns of women whose last 2 hours were exclusively category I did well; only 0.6% had 5-minute Apgar scores less than 7, and 0.2% had low Apgar scores with neonatal intensive care unit (NICU) admission. When more than 75% of the last 2 hours was category II, low 5-minute Apgar score increased to 1.3% of patients, and low 5-minute Apgar score with NICU admission increased to 0.7% (both P<.001).
Category I and category II fetal heart rate patterns are common in labor, and category III patterns are rare. Increasing time in category II in the last 2 hours of labor is associated with increased short-term newborn morbidity.
III.
估计足月单胎妊娠分娩期间和分娩前最后 2 小时内每个胎儿心率类别的时间，并估计每个类别的时间与短期新生儿结局之间的关系。
本研究回顾了 28 个月内在 10 家医院分娩的足月产妇的胎儿心率数据和新生儿结局。由产程和分娩护士评估胎儿心率特征，并使用 Eunice Kennedy Shriver 国立儿童健康与人类发育研究所的定义通过计算机分配类别。计算每个类别的持续时间，并与新生儿结局相关联。
共确定了 48444 例患者。考虑到整个产程，I 类出现 77.9%的时间，II 类出现 22.1%的时间，III 类出现 0.004%的时间。在分娩前最后 2 小时，I 类减少到持续时间的 60.9%，II 类增加到 39.1%，III 类增加到 0.006%。最后 2 小时完全为 I 类的产妇的新生儿情况良好；只有 0.6%的新生儿 5 分钟 Apgar 评分低于 7，0.2%的新生儿 Apgar 评分低并需要入住新生儿重症监护病房（NICU）。当最后 2 小时的超过 75%为 II 类时，低 5 分钟 Apgar 评分增加到 1.3%的患者，低 5 分钟 Apgar 评分且需要入住 NICU 增加到 0.7%（均 P<.001）。
I 类和 II 类胎儿心率模式在分娩中很常见，而 III 类模式很少见。分娩前最后 2 小时 II 类的时间增加与短期新生儿发病率增加有关。
III。
