Helbing W, Röpke F, Woraschk H J
Zentralbl Gynakol. 1983;105(4):198-207.
The influence of atropine sulphate (0.01 mg/kg body weight of pregnant women i.v.) on several parameters of fetal heart rate was investigated with automatic analysis of FHR. Fetal movements were counted, too. After administration of atropine, there was a first period with an "inverse" effect of atropine in all fetuses: decrease in baseline FHR (5.1%, minimum after 4.5 min) and increase in the amplitude of FHR fluctuation (44.6%). Thereafter, in a second period the "true" atropine effect appeared: increase in baseline FHR (15.5% above the level before atropine maximum after 25.1 min) and decrease in the amplitude of fluctuation (64.5%). In the third period baseline FHR returned to normal values but the amplitude of FHR fluctuation as well as the beat-to-beat irregularity remained small in 12 from 14 fetuses. Fetal movements registered by the mothers decreased significantly in this time. The results demonstrate a dualistic effect of atropine in the fetus. Moreover, the amplitude of FHR fluctuation (amplitude of macrofluctuation) and the beat-to-beat irregularity (microfluctuation) changed in an equal manner and appear to be influenced by similar regulatory processes. The divergence in the reaction of the baseline FHR and the amplitude of fluctuation together with a decrease in fetal movements might be caused by a central nervous effect with a change in the behaviour of the fetus.
通过对胎儿心率(FHR)的自动分析,研究了硫酸阿托品(静脉注射,剂量为孕妇体重0.01mg/kg)对胎儿心率多个参数的影响。同时也对胎儿胎动进行了计数。给予阿托品后,所有胎儿均出现了第一个阶段,即阿托品的“反向”作用:基线FHR下降(5.1%,4.5分钟后降至最低),FHR波动幅度增加(44.6%)。此后,在第二个阶段出现了阿托品的“真正”作用:基线FHR升高(在25.1分钟后,比阿托品作用最强时的水平高出15.5%),波动幅度降低(64.5%)。在第三个阶段,基线FHR恢复到正常值,但在14个胎儿中有12个胎儿的FHR波动幅度以及逐搏不规则性仍然较小。在此期间,母亲记录到的胎儿胎动显著减少。结果表明阿托品对胎儿有双重作用。此外,FHR波动幅度(大波动幅度)和逐搏不规则性(微波动)的变化方式相同,似乎受到相似调节过程的影响。基线FHR和波动幅度反应的差异以及胎儿胎动的减少可能是由中枢神经效应导致胎儿行为改变引起的。