Schmidt S
Institute of Perinatal Medicine, Free University of Berlin, West Germany.
J Perinat Med. 1987;15(4):377-82. doi: 10.1515/jpme.1987.15.4.377.
tcPco2 monitoring on the fetal scalp potentially is a beneficial and additional new tool for the surveillance of the unborn child. During a clinical trial we investigated the tcPco2 monitoring using the glue fixation technique. A modified Severingshaus electrode was applied on a prepared area on the fetal scalp by means of an endoscope. The attempt of application was successful in 224 out of 245 cases, while reapplication was only necessary in 8 cases. The accuracy of the tcPco2 measurement using glue fixation was sufficient at both measuring temperatures (39 degrees C and 44 degrees C). The correlation coefficient comparing the data with the tcPco2 of the fetal blood was 0.74 respectively 0.81. The development of a caput succedaneum leads to higher absolute values of the tcPco2. When a caput succedaneum has developed in the measuring area the mean value of the tcPco2 is significantly higher (62.70 mmHg instead of 55.14 mmHg respectively 68.98 mmHg instead of 65.98 mmHg) at 39 degrees C respectively 44 degrees C. No significant influence of different preparation techniques of the measuring site has been found during this investigation. The glue fixation technique leads to a reliable recording of tcPco2 in the fetus during labor, when the electrode is placed in a central and not compressed position on the lower pole of the fetus. The disadvantage is the necessity of extensive training of the personnel and the large number of instruments, factors that will interfere with a more widespread use in clinical routine.
胎儿头皮tcPco₂监测可能是一种用于监测未出生胎儿的有益且新增的工具。在一项临床试验中，我们使用胶水固定技术对tcPco₂监测进行了研究。通过内窥镜将改良的Severingshaus电极应用于胎儿头皮的准备区域。在245例病例中，224例应用尝试成功，仅8例需要重新应用。在两个测量温度（39摄氏度和44摄氏度）下，使用胶水固定进行tcPco₂测量的准确性都足够。将数据与胎儿血tcPco₂进行比较的相关系数分别为0.74和0.81。头颅血肿的出现会导致tcPco₂的绝对值更高。当测量区域出现头颅血肿时，在39摄氏度和44摄氏度下，tcPco₂的平均值显著更高（分别为62.70 mmHg而非55.14 mmHg，以及68.98 mmHg而非65.98 mmHg）。在本次研究中未发现测量部位不同准备技术的显著影响。当电极放置在胎儿下极的中央且未受压位置时，胶水固定技术可在分娩期间可靠记录胎儿的tcPco₂。缺点是需要对人员进行广泛培训且仪器数量众多，这些因素会妨碍其在临床常规中更广泛的应用。
