Mussi Serena, Incerti Maddalena, Plevani Cristina, Ghidini Alessandro, Pezzullo John C, Locatelli Anna
a Department of Obstetrics and Gynecology , San Gerardo Hospital-FMBBM, University of Milano-Bicocca , Monza , Italy .
b Perinatal Diagnostic Center, Inova Alexandria Hospital , Alexandria , VA , USA , and.
J Matern Fetal Neonatal Med. 2016 Oct;29(19):3098-103. doi: 10.3109/14767058.2015.1114088. Epub 2015 Dec 2.
To assess the factors affecting neonatal acidemia, including occurrence of tachysystole/hypertonus in fetuses exposed to oxytocin during labour and with continuously-monitored fetal heart rate (FHR) tracings.
Prospective observational study of all women with term pregnancies who received oxytocin for induction/augmentation of labour. FHR tracings were prospectively classified using ACOG classification. Independent predictors of neonatal acidemia were identified using multivariate linear regression with p < 0.05 considered significant.
We included 430 women, 236 of whom (54.9%) had spontaneous onset of labour. The duration of active phase of the second stage of labour and the presence of abnormal FHR tracing during labour were significantly associated with UA pH (p < 0.001) and BE (p < 0.001), while maximum dose of oxytocin (p < 0.17; p < 0.7) and tachysystole (p < 0.9; p < 0.8) were not. At logistic regression, the duration of active phase of the second stage of labour was independently predictive of neonatal acidemia (p < 0.009) while abnormal FHR tracing approached significance (p < 0.088).
In women receiving oxytocin during labour, the duration of active phase of the second stage of labour correlates with neonatal acidemia, whereas maximum dose of oxytocin, duration of oxytocin administration and occurrence of tachysystole during labour do not.
评估影响新生儿酸血症的因素，包括在分娩期间使用缩宫素且胎儿心率（FHR）持续监测的胎儿出现宫缩过速/张力亢进的情况。
对所有接受缩宫素引产/加强宫缩的足月妊娠妇女进行前瞻性观察研究。FHR描记图采用美国妇产科医师学会（ACOG）分类法进行前瞻性分类。使用多变量线性回归确定新生儿酸血症的独立预测因素，p < 0.05被认为具有统计学意义。
我们纳入了430名妇女，其中236名（54.9%）自然发动分娩。第二产程活跃期的持续时间以及分娩期间FHR描记图异常与脐动脉pH值（p < 0.001）和碱剩余（p < 0.001）显著相关，而缩宫素的最大剂量（p < 0.17；p < 0.7）和宫缩过速（p < 0.9；p < 0.8）则无相关性。在逻辑回归分析中，第二产程活跃期的持续时间是新生儿酸血症的独立预测因素（p < 0.009），而FHR描记图异常接近具有统计学意义（p < 0.088）。
在分娩期间接受缩宫素的妇女中，第二产程活跃期的持续时间与新生儿酸血症相关，而缩宫素的最大剂量、缩宫素给药时间以及分娩期间宫缩过速的发生情况则无关。
