Ingemarsson I, Arulkumaran S
Am J Obstet Gynecol. 1986 Jul;155(1):66-9. doi: 10.1016/0002-9378(86)90080-3.
The fetal acid-base balance from scalp blood in the early and late first stage of labor and from cord arterial blood was assessed in 120 low-risk patients only monitored electronically for 15 minutes at admission. The mean scalp blood pH values were 7.332 at a cervical dilatation of 5 cm and 7.335 at 10 cm cervical dilatation. A low pH value (less than 7.25) was found in 14 patients; five (4.2%) of them had fetal distress. Stethoscopic auscultation failed to identify these cases. Another nine patients had transient abnormal acid-base balance (a check value within 30 minutes was normal), and the fetal heart rate trace (obtained immediately after the sampling) showed no ominous changes in these cases. It is concluded that an abnormal fetal acid-base balance is not uncommon in a low-risk population in labor. However, a critical evaluation of the acid-base balance is necessary, since in most cases the abnormal acid-base balance is transient and of a respiratory, innocuous type without concomitant fetal distress.
对120例低风险患者进行了评估，这些患者在入院时仅接受了15分钟的电子监测，监测内容包括第一产程早期和晚期头皮血以及脐动脉血的胎儿酸碱平衡情况。宫颈扩张5cm时头皮血pH值平均为7.332，宫颈扩张10cm时为7.335。14例患者pH值较低（低于7.25）；其中5例（4.2%）出现胎儿窘迫。听诊未能识别出这些病例。另外9例患者有短暂的酸碱平衡异常（30分钟内复查值正常），这些病例的胎儿心率曲线（采样后立即获得）未显示出不祥变化。得出的结论是，异常的胎儿酸碱平衡在低风险产程人群中并不罕见。然而，对酸碱平衡进行严格评估是必要的，因为在大多数情况下，异常的酸碱平衡是短暂的，属于呼吸性、无害类型，且无伴随的胎儿窘迫。
