Butruille Laura, De Jonckheere Julien, Flocteil Mathilde, Garabedian Charles, Houfflin-Debarge Véronique, Storme Laurent, Deruelle Philippe, Logier Régis
Faculté de médecine Pôle Recherche, EA 4489, Environnement Périnatal et Santé, 1, place de Verdun, 59045, Lille Cedex, France.
Maison Régionale de la Recherche Clinique, INSERM CIC-IT 1403, Lille, France.
J Clin Monit Comput. 2017 Dec;31(6):1197-1202. doi: 10.1007/s10877-016-9957-y. Epub 2016 Nov 15.
Non-reassuring fetal heart rate tracings reflect an imbalance between the parasympathetic and sympathetic nervous systems. In this situation, fetal asphyxia can be suspected and may be confirmed by metabolic measurements at birth like low pH or high base deficit values. The objective of this study was to determine whether fetal asphyxia during labor is related to parasympathetic nervous system activity. This is a retrospective study of a database collected in 5 centers. Two hundred and ninety-nine fetal heart rate tracings collected during labor were analyzed. Autonomic nervous system, especially the parasympathetic nervous system, was analyzed using an original index: the FSI (Fetal Stress Index). The FSI is a parasympathetic activity evaluation based on fetal heart rate variability analysis. Infants were grouped based on normal or low pH value at birth. FSI was measured during the last 30 min of labor before birth and compared between groups. The minimum value of the FSI during the last 30 min before delivery was significantly lower in the group with the lower umbilical cord arterial pH value. In this pilot study during labor, FSI was lower in the group of infants with low arterial pH at birth.
令人担忧的胎儿心率描记图反映了副交感神经系统和交感神经系统之间的失衡。在这种情况下，可怀疑胎儿窒息，并可通过出生时的代谢指标如低pH值或高碱缺失值来确诊。本研究的目的是确定分娩期间胎儿窒息是否与副交感神经系统活动有关。这是一项对5个中心收集的数据库进行的回顾性研究。分析了分娩期间收集的299份胎儿心率描记图。使用一个原始指标：胎儿应激指数（FSI）对自主神经系统，尤其是副交感神经系统进行分析。FSI是基于胎儿心率变异性分析的副交感神经活动评估。根据出生时pH值正常或偏低对婴儿进行分组。在出生前分娩的最后30分钟测量FSI，并在两组之间进行比较。脐动脉pH值较低的组在分娩前最后30分钟内FSI的最小值显著更低。在这项分娩期间的初步研究中，出生时动脉pH值低的婴儿组的FSI较低。
