分娩期间母体姿势对胎儿脑氧合的影响。

The effect of maternal posture on fetal cerebral oxygenation during labour.

作者信息

Aldrich C J, D'Antona D, Spencer J A, Wyatt J S, Peebles D M, Delpy D T, Reynolds E O

机构信息

Department of Obstetrics and Gynaecology, University College London Medical School, UK.

出版信息

Br J Obstet Gynaecol. 1995 Jan;102(1):14-9. doi: 10.1111/j.1471-0528.1995.tb09019.x.

DOI:10.1111/j.1471-0528.1995.tb09019.x

PMID:7833304

Abstract

OBJECTIVE

To measure the effect of changes in maternal posture on fetal cerebral oxygenation during normal labour.

DESIGN

A prospective study comparing changes in the fetal cerebral concentrations of oxyhaemoglobin, deoxyhaemoglobin and cerebral blood volume, measured by near infrared spectroscopy, in women with effective epidural analgesia when moved from the left lateral to the supine position during labour.

SETTING

A London teaching hospital obstetric unit.

SUBJECTS

Fourteen women during uncomplicated labour at term.

RESULTS

When compared with the left lateral position, the supine position was associated with a significant decrease in the mean concentration of fetal cerebral oxyhaemoglobin of 1.12 (SD 1.0, 95% CI 0.49 to 1.75) mumol. 100 g-1 (P < 0.01) without any significant change in the mean concentration of deoxyhaemoglobin and cerebral blood volume. These changes were associated with a significant decrease in the mean cerebral oxygen saturation of 8.3 (SD 8.8, 95% CI 1.5 to 15.1)% (P < 0.05, n = 9).

CONCLUSION

Changes in maternal posture during labour, in women with effective epidural analgesia, are associated with a significant decrease in fetal cerebral oxygenation.

摘要

目的

测量正常分娩过程中产妇体位变化对胎儿脑氧合的影响。

设计

一项前瞻性研究，比较在分娩期间从左侧卧位改为仰卧位时，采用近红外光谱法测量的有效硬膜外镇痛产妇的胎儿脑内氧合血红蛋白、脱氧血红蛋白浓度及脑血容量的变化。

地点

伦敦一家教学医院的产科病房。

研究对象

14名足月顺产的妇女。

结果

与左侧卧位相比，仰卧位时胎儿脑氧合血红蛋白的平均浓度显著降低1.12（标准差1.0，95%可信区间0.49至1.75）μmol·100g-1（P<0.01），而脱氧血红蛋白平均浓度和脑血容量无显著变化。这些变化与平均脑氧饱和度显著降低8.3（标准差8.8，95%可信区间1.5至15.1）%相关（P<0.05，n = 9）。