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产前给予母体倍他米松后胎儿心率短期变异性的改变:两种不同计算算法的验证

Alterations of the Short-Term Variation of the Fetal Heart Rate after Antenatal Maternal Betamethasone Administration: Validation with Two Different Computational Algorithms.

作者信息

Kouskouti Christina, Jonas Hella, Levidou Georgia, Regner Kerstin, Kainer Franz

机构信息

Klinik Hallerwiese, Department of Obstetrics and Perinatal Medicine, Nurnberg.

Paracelsus Universität Nurnberg, Institute for Pathology, Nurnberg.

出版信息

Z Geburtshilfe Neonatol. 2020 Feb;224(1):26-30. doi: 10.1055/a-0873-2058. Epub 2019 Apr 11.

Abstract

INTRODUCTION

Antenatal betamethasone administration in the context of foetal lung maturity enhancement has a transient impact on the short-term variation (STV) of the foetal heart rate. There are currently various algorithms for computing the STV, each one resulting in different STV values. We studied the results of betamethasone administration on the STV using 2 different algorithms in order to investigate whether the effects of steroids on the STV depend on the algorithm used or not.

MATERIALS AND METHODS

In the context of a larger, single-centre, prospective, observational study, we gathered CTG traces under and without the influence of steroids in order to study their effect on the STV using 2 different computational algorithms (STV240 and STV16).

RESULTS

A total of 285 CTGs were registered and subsequently analysed with both algorithms. When compared to the STV240 and STV16 without or at least 72 h after the first intramuscular corticosteroid administration, a transient increase of both the STV240 and STV16 was documented in the first 24 h, followed by a transient decrease of both the STV240 and STV16 between 24 h and 72 h after the first intramuscular corticosteroid injection.

CONCLUSION

Our results confirmed that betamethasone administration has a transient but significant effect on the STV independently of the algorithm used. These observations stress once again the fact that a decreased STV within the first 72 h after maternal bethametasone administration should not be an indication for early delivery.

摘要

引言

在促进胎儿肺成熟的背景下,产前给予倍他米松对胎儿心率的短期变异性(STV)有短暂影响。目前有多种计算STV的算法,每种算法得出的STV值都不同。我们使用两种不同算法研究了倍他米松给药对STV的影响,以调查类固醇对STV的影响是否取决于所使用的算法。

材料与方法

在一项更大规模的单中心前瞻性观察性研究中,我们收集了有无类固醇影响下的产时胎心监护(CTG)记录,以便使用两种不同的计算算法(STV240和STV16)研究其对STV的影响。

结果

共记录了285份CTG,并随后用两种算法进行分析。与首次肌内注射皮质类固醇前或至少72小时后的STV240和STV16相比,首次肌内注射皮质类固醇后的前24小时内,STV240和STV16均出现短暂升高,随后在首次肌内注射皮质类固醇后的24小时至72小时之间,STV240和STV16均出现短暂下降。

结论

我们的结果证实,倍他米松给药对STV有短暂但显著的影响,与所使用的算法无关。这些观察结果再次强调了这样一个事实,即母亲给予倍他米松后72小时内STV降低不应作为早期分娩的指征。

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