Cabal L A, Devaskar U, Siassi B, Hodgman J E, Emmanouilides G
J Pediatr. 1980 Apr;96(4):705-10. doi: 10.1016/s0022-3476(80)80750-5.
Fetal and neonatal biophysical and biochemical changes were studied in four preterm infants who developed cardiogenic shock as a result of severe perinatal asphyxia. Fetal distress was documented by the presence of severe late and variable decelerations associated with decreased fetal heart rate variability. Severity of fetal acidosis was decumented by scalp and umbilical cord blood pH. Apgar scores at 1, 5, and 10 minutes were all equal to or less than 5. Although the clinical findings shortly after birth resembled respiratory distress syndrome, it was possible to make a primary diagnosis of cardiac failure with the recognition of cardiomegaly, hepatomegaly, electrocardiographic changes of myocardial hypoxia, decreased myocardial contractility, elevated central venous pressure, and severe lactic acidosis. The treatment of heart failure, including use of inotropic agents, resulted in rapid improvement in the clinical condition, with reversal of the abnormal findings within 24 to 36 hours. Concomitant with this improvement, the increase in arterial blood pressure was paralleled by increase in peripheral (toe) temperature.
对4例因严重围产期窒息而发生心源性休克的早产儿的胎儿及新生儿生物物理和生化变化进行了研究。严重晚期减速和与胎儿心率变异性降低相关的可变减速的出现记录了胎儿窘迫情况。通过头皮和脐带血pH值记录胎儿酸中毒的严重程度。出生后1分钟、5分钟和10分钟的阿氏评分均等于或小于5分。尽管出生后不久的临床表现类似呼吸窘迫综合征，但通过认识到心脏扩大、肝脏肿大、心肌缺氧的心电图变化、心肌收缩力下降、中心静脉压升高和严重乳酸酸中毒，有可能初步诊断为心力衰竭。心力衰竭的治疗，包括使用强心剂，使临床状况迅速改善，异常表现在24至36小时内逆转。随着这种改善，动脉血压的升高与外周（脚趾）温度的升高并行。
