Pardi G, Marconi A, Ferrazzi E
Br J Obstet Gynaecol. 1986 Mar;93(3):250-4. doi: 10.1111/j.1471-0528.1986.tb07902.x.
Electrocardiographs from 68 fetuses with ultrasound evidence of growth retardation were recorded from the maternal abdomen; QRS duration was measured and compared to normal standards previously obtained in our Institute. Of these fetuses, 54 were small-for-gestational-age at birth and 44 exhibited QRS duration values below -2 SD for their gestational age. All but one of the 14 normal fetuses showed normal QRS values (positive predictive value = 98%; negative predictive value = 57%). Of 11 fetuses with QRS duration values below -4 SD, nine were particularly small, below the 2nd centile of weight for gestation. QRS duration measurements may represent a sensitive method for identifying fetal growth-retardation. The QRS duration also seems to provide a reliable prognosis of perinatal outcome. Normal values are a reassuring factor: abnormal cardiotocographic records were observed in only 2 out of 23 cases and no low Apgar scores or perinatal deaths occurred. QRS values below -4 SD proved to be associated with abnormal cardiotocographic records (7/13), low Apgar scores (5/15) and perinatal deaths (3/15).
从孕妇腹部记录了68例有超声证据显示生长迟缓胎儿的心电图;测量了QRS波时限,并与本研究所先前获得的正常标准进行比较。这些胎儿中,54例出生时为小于胎龄儿,44例的QRS波时限值低于其孕周的-2标准差。14例正常胎儿中除1例之外均显示QRS值正常(阳性预测值=98%;阴性预测值=57%)。在11例QRS波时限值低于-4标准差的胎儿中,9例特别小,低于孕周体重的第2百分位数。QRS波时限测量可能是识别胎儿生长迟缓的一种敏感方法。QRS波时限似乎也能为围产期结局提供可靠的预后信息。正常数值是一个令人安心的因素:23例中仅2例观察到异常的胎心监护记录,且未发生低Apgar评分或围产期死亡。低于-4标准差的QRS值被证明与异常的胎心监护记录(7/13)、低Apgar评分(5/15)和围产期死亡(3/15)相关。