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临床催眠期间胎儿心率的频谱分析变化:一项从妊娠第20周直至足月的前瞻性随机试验。

Change of Spectral Analysis of Fetal Heart Rate During Clinical Hypnosis: a Prospective Randomised Trial from the 20th Week of Gestation Till Term.

作者信息

Reinhard J, Hayes-Gill B R, Schiermeier S, Hatzmann W, Heinrich T M, Hüsken-Janßen H, Herrmann E, Louwen F

机构信息

Obstetrics and Gynaecology Department, Johann Wolfgang Goethe University Frankfurt, Frankfurt.

School of Electrical and Electronic Engineering, University of Nottingham, Nottingham, United Kingdom.

出版信息

Geburtshilfe Frauenheilkd. 2012 Apr;72(4):316-321. doi: 10.1055/s-0031-1298399.

Abstract

To investigate the functional adaptive process of the fetal autonomic nervous system during hypnosis from the 20th week of gestation till term. Are there changes in the power spectrum analysis of fetal heart rate when the mother is having a clinical hypnosis or control period? Fourty-nine FHR recordings were analysed. Included recordings were from singletons and abdominal fetal ECG-monitored pregnancies. All women were randomised to receive clinical hypnosis followed by a period with no intervention or vice versa. Statistical analyses were performed with the Wilcoxon signed ranks and Spearman rho correlation tests. There was a significant difference found between fetal heart rate at baseline (144.3 ± 6.0) and hypnosis (142.1 ± 6.4). A difference was also detected between the standard deviation of the heart rate between baseline (6.7 ± 1.9) and hypnosis (6.8 ± 3.5). LFnu was smaller during baseline (80.2 ± 5.3) than during hypnosis (82.1 ± 5.7), whereas HFnu was significantly larger (19.8 ± 5.3 vs. 17.9 ± 5.7). There was no correlation between the gestation age and the change in LFnu, HFnu or ratio LF/HF due to the hypnosis intervention. The functional adaptive process of the fetal autonomic system during hypnosis is reflected by a sympathovagal shift towards increased sympathetic modulation.

摘要

为研究妊娠20周直至足月期间胎儿自主神经系统在催眠过程中的功能适应性过程。母亲处于临床催眠期或对照期时,胎儿心率的功率谱分析是否存在变化?对49份胎儿心率记录进行了分析。纳入的记录来自单胎妊娠以及经腹部胎儿心电图监测的妊娠。所有女性均被随机分组,一组先接受临床催眠,随后经历一段无干预期,另一组则相反。采用Wilcoxon符号秩检验和Spearman秩相关检验进行统计分析。发现基线时胎儿心率(144.3±6.0)与催眠时(142.1±6.4)存在显著差异。还检测到基线时心率标准差(6.7±1.9)与催眠时(6.8±3.5)之间存在差异。低频归一化值在基线时(80.2±5.3)低于催眠时(82.1±5.7),而高频归一化值则显著更高(分别为19.8±5.3和17.9±5.7)。由于催眠干预,胎龄与低频归一化值、高频归一化值或低频/高频比值的变化之间无相关性。催眠期间胎儿自主神经系统的功能适应性过程表现为交感-迷走神经平衡向交感神经调节增强的方向转变。

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