Köppel R, Benz J
Geburtshilfe Frauenheilkd. 1984 Sep;44(9):573-5. doi: 10.1055/s-2008-1036305.
In 871 deliveries out of a total of 3980 effected during 1980-1982 at the Winterthur Gynaecological Hospital, we found it necessary to perform one or several microanalyses of blood (blood gas analyses) sub partu. Among these, we found retrospectively that in 22 cases the microanalysis of the blood gas had prevented us from performing caesarean section which would have seemed necessary if we had relied on the cardiotocographical findings alone. Micro-analysis of blood gas made it possible to exclude the presence of pre-acidosis or acidosis which would have made Caesarean section imperative; in all these cases, normal delivery via the vagina was achieved, and in no case did this result in severe acidosis. All newborn had a 5-minute Apgar score of 7 and higher. We can conclude from these results, therefore, that the indication for an immediate termination of delivery via Caesarean section should not depend solely on a pathological cardiotocogram; the final decision should be arrived at only after micro-analyses of blood gas have confirmed the presence of foetal pre-acidosis or acidosis.
在1980 - 1982年期间，温特图尔妇科医院共进行了3980次分娩，其中871例分娩时，我们认为有必要在分娩期进行一次或多次血液微量分析（血气分析）。回顾这些病例，我们发现有22例通过血气微量分析避免了剖宫产，如果仅依据胎心监护结果，剖宫产似乎是必要的。血气微量分析能够排除可能导致必须进行剖宫产的酸中毒前期或酸中毒情况；在所有这些病例中，均实现了经阴道正常分娩，且无一例导致严重酸中毒。所有新生儿5分钟阿氏评分均为7分及以上。因此，从这些结果我们可以得出结论，立即剖宫产的指征不应仅取决于病理性胎心监护图；只有在血气微量分析确认存在胎儿酸中毒前期或酸中毒后，才能做出最终决定。
