Devoe L D, Gardner P, Arnold P, Searle N
Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta 30912.
Am J Obstet Gynecol. 1989 May;160(5 Pt 1):1086-90. doi: 10.1016/0002-9378(89)90166-x.
Fetal heart rate responses to vibratory acoustic stimulation have been studied in normal and complicated pregnancies. To determine the precise nature of these responses, we studied 50 normal term fetuses with 60 minutes of electronic antepartum fetal heart rate monitoring divided in two 30-minute segments separated by 3 seconds of vibratory acoustic stimulation. All tracings were analyzed by a programmed microcomputer. Comparison of grouped mean 30-minute values before and after vibratory acoustic stimulation showed significant increases in baseline fetal heart rate, fetal heart rate variation, frequency of accelerations exceeding 10 and 15 beats/min, duration of accelerations exceeding 15 beats/min, and frequency of decelerations after vibratory acoustic stimulation. Mean baseline fetal heart rate elevation greater than 10 beats/min occurred within 7.6 +/- 4.4 seconds in 42 of 50 fetuses and lasted for 596 +/- 531 seconds. Reactive tests increased from 35 (70%) to 47 (94%) after vibratory acoustic stimulation. Most healthy term fetuses exhibit fetal heart rate responses after differing in frequency or magnitude from spontaneous fetal heart rate changes. Vibratory acoustic stimulation may be a valid fetal assessment tool but cannot be considered the physiologic equivalent of nonstress testing.
已对正常妊娠和复杂妊娠中胎儿心率对振动声刺激的反应进行了研究。为了确定这些反应的确切性质，我们对50例足月正常胎儿进行了研究，采用电子产前胎儿心率监测60分钟，分为两个30分钟时段，中间间隔3秒的振动声刺激。所有记录均由一台程控微型计算机进行分析。对振动声刺激前后分组的30分钟平均值进行比较，结果显示振动声刺激后胎儿基线心率、胎儿心率变异性、超过10次和15次/分钟的加速频率、超过15次/分钟的加速持续时间以及减速频率均有显著增加。50例胎儿中有42例在7.6±4.4秒内平均基线胎儿心率升高超过10次/分钟，并持续596±531秒。振动声刺激后反应性试验从35例（70%）增加到47例（94%）。大多数健康足月胎儿的心率反应在频率或幅度上与胎儿自发心率变化不同。振动声刺激可能是一种有效的胎儿评估工具，但不能被视为与无应激试验具有生理等效性。
