Krebs H B, Petres R E, Dunn L J, Segreti A
Am J Obstet Gynecol. 1980 Sep 15;138(2):213-9. doi: 10.1016/0002-9378(80)90038-1.
Heart rate tracings and outcome in 919 electively and 1,077 nonelectively monitored fetuses were compared in order to investigate the value of elective surveillance of the fetal heart rate (FHR) in either group. A threefold higher perinatal mortality and a twofold higher number of low 5-minute Apgar scores were observed among patients with risk factors compared to electively monitored pregnancies. In the beginning of monitored labor, fetuses with risk factors exhibited a higher incidence of FHR patterns with low FHR variability than fetuses without risk factors. In the final phase of labor, FHR patterns indicative of hypoxia, i.e., late decelerations and severe and atypical variable decelerations, were found more often in the nonelective than in the elective group. Umbilical cord problems reflected by the occurrence of variable deceleration were responsible for the majority of low Apgar scores observed among electively monitored fetuses. The findings and their implications for FHR monitoring are discussed.
比较了919例择期监测和1077例非择期监测胎儿的心率描记图及结局，以研究两组中胎儿心率（FHR）择期监测的价值。与择期监测的妊娠相比，有危险因素的患者围产期死亡率高三倍，5分钟阿氏评分低的数量高二倍。在监测产程开始时，有危险因素的胎儿出现FHR变异低的模式的发生率高于无危险因素的胎儿。在产程的最后阶段，提示缺氧的FHR模式，即晚期减速和严重及非典型可变减速，在非择期组比择期组更常见。可变减速的发生所反映的脐带问题是择期监测胎儿中观察到的大多数低阿氏评分的原因。讨论了这些发现及其对FHR监测的意义。
