Arabin B, Zacharias C, Riedewald S, Blücher U, Saling E
Institut für Perinatale Medizin der FU Berlin.
Geburtshilfe Frauenheilkd. 1989 Jul;49(7):653-7. doi: 10.1055/s-2008-1026672.
The aim of the study was to standardize the types of fetal reactions to a short acoustical stimulation in relation to gestational age and the fetal behavioural state. We used polygraphic monitoring in 74 normal pregnancies to investigate the types of fetal reactions after an acoustical stimulation with a bell or a so-called larynx vibrator. A distinction was made between a very short reaction and a so-called long-term reaction with a long-lasting change in a fetal behavioural pattern. After the 26th gestational week, we observed at the so-called "passive" fetal stage a fetal reaction to the bell in 80% and a reaction to the vibrator in 100%. In the "active" fetal state, there was only a reaction in 54 and 62% of the fetuses respectively. The number of "long-lasting" reactions was relatively increased in the active state and after stimulation with the vibrator. After stimulation with the bell and the vibrator, the actocardiograph tracing showed a heart-rate acceleration in 76% and 61% respectively and a so-called cluster of fetal movements in 88% and 100% respectively. A fetal reaction to acoustical stimulation can be diagnosed most accurately by combining the heart-rate acceleration and the clustering of fetal movements. It still has to be checked to what extent a negative response to acoustical stimulation is indicative of possible fetal distress. In cases with negative tests, further monitoring methods have to be applied in order to exclude fetal hypoxia.
本研究的目的是根据胎龄和胎儿行为状态,规范胎儿对短时间声学刺激的反应类型。我们对74例正常妊娠进行了多导监测,以研究使用铃铛或所谓的喉部振动器进行声学刺激后胎儿的反应类型。区分了非常短的反应和所谓的长期反应,后者胎儿行为模式会发生持久变化。在妊娠第26周后,在所谓的“被动”胎儿阶段,我们观察到80%的胎儿对铃铛有反应,100%的胎儿对振动器有反应。在“活跃”胎儿状态下,分别只有54%和62%的胎儿有反应。“持久”反应的数量在活跃状态下以及使用振动器刺激后相对增加。在使用铃铛和振动器刺激后,心动描记图分别显示76%和61%的胎儿心率加速,88%和100%的胎儿出现所谓的胎儿运动簇。结合心率加速和胎儿运动簇可以最准确地诊断胎儿对声学刺激的反应。仍需检查对声学刺激的阴性反应在何种程度上表明可能存在胎儿窘迫。在测试结果为阴性的情况下,必须应用进一步的监测方法以排除胎儿缺氧。