Lin C C, Pielet B W, Poon E, Sun G
Department of Obstetrics and Gynecology, University of Chicago, IL 60637.
Am J Perinatol. 1988 Jul;5(3):208-13. doi: 10.1055/s-2007-999687.
Forty-two preeclamptic patients between 36 and 41 weeks gestation were investigated for baseline fetal heart rate (FHR) variability 1 hour after the initiation of magnesium therapy, at midlabor, and at the time of delivery. With a standard regimen of intravenous magnesium sulfate therapy, the mean maternal serum magnesium levels at the three different sampling times were statistically different (f = 6.94, p less than 0.01 by one-way analysis of variance), documenting the cumulative effect of continuous intravenous magnesium administration. The majority of the fetuses (86%) that exhibited a decrease in long-term FHR variability were associated with a maternal serum magnesium level above the lower limit of the therapeutic range (4.8 mg/dl). Of all fetuses whose maternal serum magnesium levels were 4.8 mg/dl or greater at delivery, only 40% exhibited a decrease in FHR variability. A higher mean maternal magnesium level, a higher mean cord blood magnesium level, and a higher total dose of magnesium sulfate were observed in the group of fetuses showing a decrease in FHR variability than in the group showing no change in FHR variability. The good fetal outcome seen in both study populations suggests that the effect of magnesium sulfate on FHR variability is a transient, reversible phenomenon that should not be considered as a sign of fetal distress.
对42例孕周在36至41周的子痫前期患者，在镁剂治疗开始后1小时、产程中及分娩时进行了基线胎心率（FHR）变异性调查。采用标准的静脉硫酸镁治疗方案，三个不同采样时间点的平均母体血清镁水平在统计学上存在差异（通过单因素方差分析，F = 6.94，p < 0.01），证明了持续静脉输注镁剂的累积效应。大多数长期FHR变异性降低的胎儿（86%）与母体血清镁水平高于治疗范围下限（4.8 mg/dl）有关。在分娩时母体血清镁水平为4.8 mg/dl或更高的所有胎儿中，只有40%的胎儿FHR变异性降低。与FHR变异性无变化的胎儿组相比，FHR变异性降低的胎儿组母体平均镁水平更高、脐血平均镁水平更高且硫酸镁总剂量更高。两个研究人群中均观察到良好的胎儿结局，这表明硫酸镁对FHR变异性的影响是一种短暂的、可逆的现象，不应被视为胎儿窘迫的迹象。
