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新型经腹胎儿血氧计在缺氧胎儿羊模型中的验证。

Validation of a Novel Transabdominal Fetal Oximeter in a Hypoxic Fetal Lamb Model.

机构信息

Electrical and Computer Engineering, University of California Davis, Davis, CA, USA.

Department of Surgery, University of California Davis Health, Sacramento, CA, USA.

出版信息

Reprod Sci. 2020 Oct;27(10):1960-1966. doi: 10.1007/s43032-020-00215-5. Epub 2020 Jun 15.

Abstract

Current intrapartum fetal oxygen saturation (SaO2) monitoring methodologies are limited, mostly consisting of fetal heart rate monitoring which is a poor predictor of fetal hypoxia. A newly developed transabdominal fetal oximeter (TFO) may be able to determine fetal SaO2 non-invasively. This study is to validate a novel TFO in determining fetal SaO2 in a hypoxic fetal lamb model. Fetal hypoxia was induced in at-term pregnant ewe by placing an aortic occlusion balloon infrarenally and inflating it in a stepwise fashion to decrease blood flow to the uterine artery. The inflation was held at each step for 10 min, and fetal arterial blood gases (ABGs) were intermittently recorded from the fetal carotid artery. The balloon catheter was deflated when fetal SaO2 fell below 15%, and the fetus was recovered. A total of three desaturation experiments were performed. The average fetal SpO2 reported by the TFO was derived at each hypoxic level and correlated with the ABG measures. Fetal SaO2 from the ABGs ranged from 10.5 to 66%. The TFO SpO2 correlated with the ABG fetal SaO2 (r-squared = 0.856) with no significant differences (p > 0.5). The fetal SpO2 measurements from TFO were significantly different than the maternal SpO2 (p < 0.01), which suggests that the transcutaneous measurements are penetrating through the maternal abdomen sufficiently and are expressing the underlying fetal tissue physiology. The recently developed TFO system was able to non-invasively report the fetal SpO2, which showed strong correlation with ABG measures and showed no significant differences.

摘要

目前的产时胎儿血氧饱和度(SaO2)监测方法有限,主要包括胎心监护,但它是胎儿缺氧的预测指标较差。一种新开发的经腹胎儿血氧计(TFO)可能能够无创地确定胎儿的 SaO2。本研究旨在验证一种新的 TFO 在缺氧胎儿羊模型中确定胎儿 SaO2 的能力。通过在肾下放置主动脉阻塞球囊并逐步充气来减少子宫动脉血流,在足月妊娠母羊中诱导胎儿缺氧。在每个步骤保持充气 10 分钟,并且从胎儿颈动脉间歇性记录胎儿动脉血气(ABG)。当胎儿 SaO2 下降到 15%以下时,气球导管被放气,胎儿被恢复。总共进行了三次去饱和度实验。在每个缺氧水平下报告 TFO 的平均胎儿 SpO2,并与 ABG 测量值相关联。ABG 中胎儿 SaO2 的范围为 10.5 至 66%。TFO SpO2 与 ABG 胎儿 SaO2 相关(r-squared=0.856),无显着差异(p>0.5)。TFO 的胎儿 SpO2 测量值与母体 SpO2 显着不同(p<0.01),这表明经皮测量值足以穿透母体腹部并表达潜在的胎儿组织生理学。最近开发的 TFO 系统能够无创地报告胎儿 SpO2,与 ABG 测量值具有很强的相关性,并且没有显着差异。

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