Bohiltea Roxana-Elena, Mihai Bianca Margareta, Ducu Ioniță, Cioca Ana-Maria, Bohiltea Alexia-Teodora, Iordache Ana-Maria, Iordache Stefan-Marian, Grigorescu Cristiana Eugenia Ana, Marinescu Silviu
Department of Obstetrics and Gynecology, "Carol Davila" University of Medicine and Pharmacy Bucharest, 37 Dionisie Lupu, 020021 Bucharest, Romania.
Department of Obstetrics, Gynecology and Neonatology, Filantropia Hospital, 11-13 Ion Mihalache Blv., Sector 1, 011171 Bucharest, Romania.
Diagnostics (Basel). 2022 Nov 3;12(11):2675. doi: 10.3390/diagnostics12112675.
In this study, we explore the "why?", and "how?", monitoring the pH of the fetal scalp is used, and show its limitations. In addition, we review the development of new devices based on the modern physics and nanomaterials serving this topic. Most of the works we found in our search have focused on improving the prognostic of fetal heart rate monitoring, because it is the "golden standard" in determining fetal distress. Although the best-known screening method, it can only provide limited information about the actual status of the fetus. The best predictive assessment, with the highest reproducibility, states that a normal fetal heart rate is indicative of a healthy baby. However, its excellent sensitivity is much reduced when identifying the actual "distress". This is when second-line monitoring methods come into play to guide the diagnostics and direct the obstetrician towards an action plan. Although a historic method, fetal scalp pH sampling is still under review as to its efficiency and place in the current obstetrics. Continuous surveillance of the fetal parameters is important, especially for the fetuses undergoing intrauterine growth restricted (IUGR). Since fetal scalp blood sampling is still under research and is a randomized controlled trial, which compares the relevance of pH and lactates to the obstetrical situation, the maternal-fetal medicine could greatly benefit from the introduction of engineered nanomedicines to the field.
在本研究中,我们探究了使用胎儿头皮pH监测的“原因”及“方式”,并指出了其局限性。此外,我们回顾了基于现代物理学和纳米材料用于该主题的新设备的发展情况。我们在搜索中发现的大多数研究都集中在改善胎儿心率监测的预后,因为它是确定胎儿窘迫的“金标准”。尽管这是最广为人知的筛查方法,但它只能提供关于胎儿实际状况的有限信息。最具可重复性的最佳预测评估表明,正常的胎儿心率表明胎儿健康。然而,在识别实际的“窘迫”时,其出色的敏感性会大大降低。此时二线监测方法就发挥作用,以指导诊断并为产科医生指明行动计划。尽管胎儿头皮pH采样是一种历史悠久的方法,但就其效率以及在当前产科中的地位仍在进行审视。持续监测胎儿参数很重要,尤其是对于那些经历宫内生长受限(IUGR)的胎儿。由于胎儿头皮血采样仍在研究中,且是一项随机对照试验,比较了pH值和乳酸与产科情况的相关性,母胎医学领域引入工程纳米药物可能会大有裨益。