Bergmans M G, van Geijn H P, van Kessel H, Puyenbroek J I, Arts N F
Department of Obstetrics and Gynecology, Free University of Amsterdam, The Netherlands.
J Perinat Med. 1987;15(4):369-76. doi: 10.1515/jpme.1987.15.4.369.
Because asphyxia is not the only factor influencing fetal heart rhythm, a non-optimal cardiotachogram is not necessarily a sign of fetal distress. It makes further evaluation of the fetal condition advisable, especially determination of the acid-base equilibrium. The method of fetal blood sampling, introduced by Saling, has a number of disadvantages for mother and fetus, because of the invasiveness for both. Further, the measured acid-base equilibrium is only representative for a very short period of time and often repeated micro-blood sampling is necessary. A major problem with regard to determination of the acid-base equilibrium in intermittently obtained fetal blood samples is the inclusion of air bubbles in the sample. When they are introduced into the electrode cuvettes, the measured values cannot be considered reliable. The problem was solved in the Department of Obstetrics and Gynecology of the Vrije Universiteit of Amsterdam with a "pipe" shaped special collecting vessel. Similar measuring results were obtained with the formerly used glass capillary method and the special collecting vessel method. Continuous, non-invasive methods have been pursued to avoid the above mentioned problems. Fetal transcutaneous Po2 measurement has been possible for years, but does not provide adequate information during the important second stage of labor because of methodological problems. Continuous fetal tissue pH surveillance is possible, but it also has an invasive character and is technically difficult to perform, leading to many methodological failures. Recently, continuous transcutaneous Pco2 measurement tcPco2 became available. A good correlation was found with simultaneously measured Pco2 levels in fetal blood samples and with those of umbilical artery blood.(ABSTRACT TRUNCATED AT 250 WORDS)
由于窒息并非影响胎儿心律的唯一因素，因此胎心图不理想不一定意味着胎儿窘迫。对胎儿状况进行进一步评估是可取的，尤其是确定酸碱平衡。萨林提出的胎儿采血方法对母亲和胎儿都有一些缺点，因为对两者都有侵入性。此外，测得的酸碱平衡仅在很短一段时间内具有代表性，通常需要反复采集微量血样。在间歇性采集的胎儿血样中测定酸碱平衡的一个主要问题是样本中混入气泡。当它们进入电极比色皿时，测得的值就不可靠了。阿姆斯特丹自由大学妇产科用一种“管状”特殊采集容器解决了这个问题。使用以前的玻璃毛细管法和特殊采集容器法获得了相似的测量结果。人们一直在探索连续、无创的方法来避免上述问题。多年来，胎儿经皮氧分压测量一直可行，但由于方法学问题，在分娩的重要第二阶段无法提供足够的信息。连续胎儿组织pH监测是可行的，但它也具有侵入性，技术上难以实施，导致许多方法学上的失败。最近，连续经皮二氧化碳分压测量（tcPco2）变得可行。发现它与同时测得的胎儿血样中二氧化碳分压水平以及脐动脉血中的二氧化碳分压水平有良好的相关性。（摘要截取自250字）
