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测定胎儿头皮血样pH值作为剖宫产术中胎儿健康状况受损的指标

Determination of Foetal Scalp Blood Sampling pH as an Indicator of Loss of Foetal Well-Being in Women Undergoing Caesarean Section.

作者信息

Alarcón-Rodríguez Raquel, Martín-Álvarez María Paz, García-González Jessica, Requena-Mullor Mar, Rodríguez-García Mª Carmen, Zheng Ruirui, Rey Raúl Romero-Del

机构信息

Department of Nursing, Physiotherapy, and Medicine, University of Almería, 04120 Almería, Spain.

Midwife in Poniente Hospital, 04700 Almería, Spain.

出版信息

Healthcare (Basel). 2023 Mar 2;11(5):725. doi: 10.3390/healthcare11050725.

DOI:10.3390/healthcare11050725
PMID:36900730
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10001157/
Abstract

Asphyxia during birth is one of the three leading causes of neonatal morbidity and mortality among newborns carried to term. The objective of this study was to evaluate the measurement of the foetal scalp blood pH as a measure of foetal status, evaluating: cord gases, meconium-stained fluid, APGAR score or the need for neonatal resuscitation in pregnant women undergoing caesarean sections. A cross-sectional study was carried out over a period of 5 years (2017-2021) at the Hospital de Poniente (southern Spain). A total of 127 pregnant women participated from whom a foetal scalp blood pH sample was taken and used to indicate the need for an urgent caesarean section. The results showed a correlation between the pH of the scalp blood and the pH of the umbilical cord artery, umbilical cord vein (Rho of Spearman arterial pH: 0.64, < 0.001; Rho of Spearman venous pH: 0.58, < 0.001) and the APGAR test one minute after delivery (Spearman's Rho coefficient of 0.33, < 0.01). These results suggest that the foetal scalp pH should not be considered a foolproof method to indicate an urgent caesarean section. Foetal scalp pH sampling can be used as a complementary test, in conjunction with cardiotocography, to indicate whether an emergency caesarean section is necessary due to loss of foetal well-being.

摘要

出生时窒息是足月新生儿发病和死亡的三大主要原因之一。本研究的目的是评估胎儿头皮血pH值测量作为胎儿状况指标的情况,评估内容包括:剖宫产孕妇的脐血气、胎粪污染羊水、阿氏评分或新生儿复苏需求。在西班牙南部的波尼恩特医院进行了一项为期5年(2017 - 2021年)的横断面研究。共有127名孕妇参与,采集了她们的胎儿头皮血pH值样本,并用于指示是否需要紧急剖宫产。结果显示,头皮血pH值与脐动脉、脐静脉pH值之间存在相关性(斯皮尔曼相关系数:动脉pH值为0.64,<0.001;静脉pH值为0.58,<0.001),以及与出生后一分钟的阿氏评分之间存在相关性(斯皮尔曼相关系数为0.33,<0.01)。这些结果表明,胎儿头皮pH值不应被视为指示紧急剖宫产的万无一失的方法。胎儿头皮pH值采样可作为一种补充检查,与胎心监护一起,用于指示是否因胎儿状况不佳而需要进行紧急剖宫产。

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本文引用的文献

1
How to reduce fetal scalp blood sampling? A retrospective study evaluating the diagnostic value of scalp stimulation to predict fetal wellbeing assessed by scalp blood sampling.如何减少胎儿头皮血采样?一项回顾性研究评估了头皮刺激预测胎儿健康的诊断价值,通过头皮血采样来评估。
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Accuracy of intrapartum fetal blood gas analysis by scalp sampling: A retrospective cohort study.经头皮取样进行产时胎儿血气分析的准确性:一项回顾性队列研究。
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9
Predictive value of fetal scalp pH and base excess for fetal acidosis and poor neonatal outcome.胎儿头皮pH值和碱剩余对胎儿酸中毒及新生儿不良结局的预测价值。
J Matern Fetal Neonatal Med. 2018 Dec;31(23):3166-3171. doi: 10.1080/14767058.2017.1365132. Epub 2017 Aug 17.
10
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