Arabin B, Lorenz U, Rüttgers H, Kubli F
Universitat-Frauenklinik Heidelberg, West Germany.
Am J Perinatol. 1988 Jul;5(3):272-7. doi: 10.1055/s-2007-999702.
The present study concerns the developmental character of the fetal heart rate (FHR) pattern and the implications of predicting the perinatal outcome. Data from 443 patients undergoing 2193 nonstress tests were analyzed retrospectively. We found a significant increase of accelerations more than 15 beats/min, of accelerations associated with fetal movements, of fetal movements registered by the tocotransducer, the frequency of oscillations, and of the Fischer score values throughout gestation. The number of short FHR decreases and the mean baseline level declined throughout gestation. A long duration of absent or reduced baseline variability registered even 6 weeks before delivery was associated with low Apgar score values. Late decelerations and contractions registered early in pregnancy were also correlated to a poor outcome. Tachycardia and a low number of accelerations were only correlated to a poor perinatal outcome shortly before the delivery. Fetal movements not associated with FHR accelerations were an early indicator of a poor neonatal outcome. Scoring systems did not generally improve the predictive value of FHR patterns.
本研究关注胎儿心率（FHR）模式的发育特征及其对围产期结局预测的意义。对443例接受2193次无应激试验的患者数据进行回顾性分析。我们发现，在整个孕期，每分钟加速超过15次的加速次数、与胎动相关的加速次数、由宫缩传感器记录的胎动次数、振荡频率以及菲舍尔评分值均显著增加。短时间FHR下降的次数和平均基线水平在整个孕期均下降。即使在分娩前6周记录到的长时间基线变异缺失或减少也与低阿氏评分值相关。妊娠早期记录到的晚期减速和宫缩也与不良结局相关。心动过速和加速次数少仅在分娩前不久与不良围产期结局相关。与FHR加速无关的胎动是新生儿结局不良的早期指标。评分系统一般不能提高FHR模式的预测价值。
