Goodlin R C, Haesslein H C
Am J Obstet Gynecol. 1977 Dec 15;129(8):845-56. doi: 10.1016/0002-9378(77)90518-x.
Acute and abrupt fetal bradycardia are considered to be vagal in origin. In addition to head compression and funis compression bradycardias, we will report on those acute fetal bradycardias occurring during maternal seizures and maternal voiding, during aortocaval compression, during terminal labor, and during the immediate postpartum period. While certain mechanisms are known which can explain some or parts of these bradycardias, we conclude that in the clinical setting information is insufficient to determine their etiology with precision. Instead of labeling abrupt fetal heart rate pattern as resulting from either head or funis compression, it is suggested that the patterns be described according to their severity and duration. Such acute fetal bradycardias can be detrimental in terms of reduced umbilical flow. Administration of atropine may be indicated in the otherwise healthy fetus with acute bradycardia.
急性和突发性胎儿心动过缓被认为起源于迷走神经。除了头部受压和脐带受压导致的心动过缓外，我们还将报告在产妇癫痫发作和排尿期间、主动脉腔静脉受压期间、分娩末期以及产后即刻发生的急性胎儿心动过缓。虽然已知某些机制可以解释这些心动过缓的部分情况，但我们得出结论，在临床环境中，信息不足以精确确定其病因。建议不要将突发性胎儿心率模式标记为由头部或脐带受压引起，而是根据其严重程度和持续时间来描述这些模式。这种急性胎儿心动过缓可能会因脐血流减少而有害。对于其他方面健康但发生急性心动过缓的胎儿，可能需要使用阿托品。
