Garabedian C, De Jonckheere J, Butruille L, Deruelle P, Storme L, Houfflin-Debarge V
EA 4489, perinatal growth and environment, university Lille, 59000 Lille, France; Department of obstetrics, Jeanne-de-Flandre hospital, CHU Lille, 59000 Lille, France.
EA 4489, perinatal growth and environment, university Lille, 59000 Lille, France; CIC-IT 1403, Maison Régionale de la Recherche Clinique, CHU Lille, 59000 Lille, France.
J Gynecol Obstet Hum Reprod. 2017 Feb;46(2):113-117. doi: 10.1016/j.jogoh.2016.11.005. Epub 2017 Jan 30.
Cardiotocography (CTG) is a technique used to monitor intrapartum fetal condition and is one of the most common obstetric procedures. Second line methods of fetal monitoring have been developed in an attempt to reduce unnecessary interventions due to continuous cardiotocography and to better identify fetuses at risk of intrapartum asphyxia. The acid-base balance of the fetus is evaluated by fetal blood scalp samples, the modification of the myocardial oxygenation by the fetal ECG ST-segment analysis (STAN) and the autonomic nervous system by the power spectral analysis of the fetal heart variability. To correctly interpret the features observed on CTG traces or second line methods, it seems important to understand normal physiology during labor and the compensatory mechanisms of the fetus in case of hypoxemia. Therefore, the aim of this review is first to describe fetal physiology during labor and then to explain the modification of the second line monitoring during labor.
胎心监护（CTG）是一种用于监测产时胎儿状况的技术，是最常见的产科检查方法之一。为了减少因持续胎心监护导致的不必要干预，并更好地识别有产时窒息风险的胎儿，已开发出二线胎儿监测方法。通过胎儿头皮血样评估胎儿的酸碱平衡，通过胎儿心电图ST段分析（STAN）评估心肌氧合的变化，通过胎儿心率变异性的功率谱分析评估自主神经系统。为了正确解读胎心监护曲线或二线方法中观察到的特征，了解分娩期间的正常生理以及胎儿在低氧血症情况下的代偿机制似乎很重要。因此，本综述的目的首先是描述分娩期间的胎儿生理，然后解释分娩期间二线监测的变化。
