Graatsma E M, Mulder E J H, Vasak B, Lobmaier S M, Pildner von Steinburg S, Schneider K T M, Schmidt G, Visser G H A
Department of Obstetrics & Gynaecology, University Medical Centre Utrecht , The Netherlands.
J Matern Fetal Neonatal Med. 2012 Dec;25(12):2517-22. doi: 10.3109/14767058.2012.704446. Epub 2012 Jul 19.
To study fetal heart rate (FHR), its short term variability (STV), average acceleration capacity (AAC), and average deceleration capacity (ADC) throughout uncomplicated gestation, and to perform a preliminary comparison of these FHR parameters between small-for dates (SFD) and control fetuses.
Prospective observational study of 7 h FHR-recordings obtained with a fetal-ECG monitor in the second half of uncomplicated pregnancies (n = 90) and pregnancies complicated by fetal SFD (n = 30). FHR and STV were calculated according to established analysis. True beat-to-beat FHR, recorded at 1 ms accuracy, was used to calculate AAC and ADC using Phase Rectified Signal Averaging (PRSA). Mean values of FHR, STV, AAC, and ADC derived from recordings in SFD fetuses were compared with the reference curves.
Compared with the control group the mean z-scores for STV, AAC, and ADC in SFD fetuses were lower by 1.0 SD, 1.5 SD, and 1.7 SD, respectively (p < 0.0001 for all comparisons). In SFD fetuses, both the AAC and ADC z-scores were lower than the STV z-scores (p < 0.02 and p < 0.002, respectively).
Analysis of the AAC and ADC as recorded with a high resolution fECG recorder may differentiate better between normal and SFD fetuses than STV.
研究正常孕期胎儿心率（FHR）、其短期变异性（STV）、平均加速能力（AAC）和平均减速能力（ADC），并对小于胎龄（SFD）胎儿与对照胎儿的这些FHR参数进行初步比较。
对使用胎儿心电图监测仪在正常妊娠后半期（n = 90）和合并胎儿SFD的妊娠（n = 30）中获得的7小时FHR记录进行前瞻性观察研究。FHR和STV根据既定分析方法计算。以1毫秒精度记录的逐搏真实FHR用于通过相整流信号平均（PRSA）计算AAC和ADC。将SFD胎儿记录中的FHR、STV、AAC和ADC平均值与参考曲线进行比较。
与对照组相比，SFD胎儿中STV、AAC和ADC的平均z分数分别低1.0标准差、1.5标准差和1.7标准差（所有比较p < 0.0001）。在SFD胎儿中，AAC和ADC的z分数均低于STV的z分数（分别为p < 0.02和p < 0.002）。
使用高分辨率胎儿心电图记录仪记录的AAC和ADC分析，可能比STV能更好地区分正常胎儿和SFD胎儿。
