Chauhan S P, Cowan B D, Martin J N, Morrison J C
Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson 39216-4505, USA.
J Reprod Med. 1995 Aug;40(8):561-4.
The objective of this study was to determine if the discriminatory intrapartum amniotic fluid index can reliably predict respiratory or metabolic acidosis in the newborn.
Among 256 parturients at 37 weeks' gestation or more, the intrapartum amniotic fluid index was obtained in early labor, and umbilical arterial blood gas analysis was performed within 30 minutes of delivery. The mean (+/- SD) amniotic fluid indices in labor among newborns with no acidosis versus those with respiratory or metabolic acidosis were compared. A receiver operating characteristic curve was used to determine the best discriminatory intrapartum amniotic fluid index for respiratory and metabolic acidosis.
Statistical analysis revealed that the mean intrapartum amniotic fluid index among 12 newborns with respiratory acidosis and 26 with metabolic acidosis was significantly lower than the mean index in 218 newborns without fetal acidemia. Despite the differences in the mean intrapartum amniotic fluid index in the three groups analyzed, the receiver operating characteristic curve indicated that an intrapartum amniotic fluid index alone is a poor test for predicting acidosis (respiratory or metabolic) in the neonate.
The mean intrapartum amniotic fluid index in labor among newborns with respiratory or metabolic acidosis was significantly lower than that among nonacidotic newborns. The receiver operating characteristic curve indicated that the intrapartum amniotic fluid index cannot reliably distinguish nonacidotic infants from those with respiratory or metabolic acidosis.
本研究的目的是确定分娩期羊水指数是否能够可靠地预测新生儿呼吸性或代谢性酸中毒。
在256例妊娠37周及以上的产妇中，于产程早期获取羊水指数，并在分娩后30分钟内进行脐动脉血气分析。比较无酸中毒新生儿与呼吸性或代谢性酸中毒新生儿产程中的平均（±标准差）羊水指数。采用受试者工作特征曲线确定用于呼吸性和代谢性酸中毒的最佳分娩期鉴别羊水指数。
统计分析显示，12例呼吸性酸中毒新生儿和26例代谢性酸中毒新生儿的分娩期平均羊水指数显著低于218例无胎儿酸血症新生儿的平均指数。尽管分析的三组分娩期平均羊水指数存在差异，但受试者工作特征曲线表明，仅分娩期羊水指数对预测新生儿酸中毒（呼吸性或代谢性）效果不佳。
呼吸性或代谢性酸中毒新生儿产程中的平均羊水指数显著低于非酸中毒新生儿。受试者工作特征曲线表明，分娩期羊水指数无法可靠地区分非酸中毒婴儿与呼吸性或代谢性酸中毒婴儿。
