Painter M J
Division of Child Neurology, Children's Hospital of Pittsburgh, PA 15213.
Pediatr Neurol. 1989 May-Jun;5(3):137-44. doi: 10.1016/0887-8994(89)90062-3.
Hypoxic-ischemic injury, occurring during the intrapartum period, remains the most controversial perinatal cause of central nervous system injury. Current evidence suggests that injury during the intrapartum period is uncommon. The most widely used technique for antenatal surveillance is fetal heart rate monitoring. Fetal heart rate abnormalities, however, are infrequently associated with long-term adverse outcomes. Fetuses may manifest many minutes of "ominous" fetal heart rate patterns without evidence of irreversible central nervous system injury. Neurologically abnormal fetuses also may manifest abnormal fetal heart rate patterns because of neural mechanisms controlling heart rate, rather than because of intrapartum hypoxic events. Fetal acidosis also correlates poorly with outcome. The conclusion that a child's neurologic abnormalities are due to brain injury occurring during the intrapartum period cannot be based on fetal surveillance findings in isolation, but must be based on the consideration of many parameters.
缺氧缺血性损伤发生在分娩期，仍然是围产期中枢神经系统损伤最具争议的原因。目前的证据表明，分娩期损伤并不常见。产前监测最广泛使用的技术是胎儿心率监测。然而，胎儿心率异常很少与长期不良后果相关。胎儿可能会出现许多分钟的“不祥”胎儿心率模式，但没有不可逆中枢神经系统损伤的证据。神经系统异常的胎儿也可能由于控制心率的神经机制而出现异常胎儿心率模式，而不是因为分娩期缺氧事件。胎儿酸中毒与预后的相关性也很差。不能仅凭胎儿监测结果就得出儿童神经异常是由于分娩期发生的脑损伤这一结论，而必须综合考虑许多参数。
