分娩第一阶段的晚期胎儿心率减速及脑氧合变化
Late fetal heart decelerations and changes in cerebral oxygenation during the first stage of 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):9-13. doi: 10.1111/j.1471-0528.1995.tb09018.x.
OBJECTIVE
To test the hypothesis that late fetal heart rate decelerations are associated with a decrease in cerebral oxygenation.
DESIGN
Changes in fetal cerebral concentrations of oxyhaemoglobin and deoxyhaemoglobin were measured by near infrared spectroscopy, before, during and after contractions with late fetal heart rate decelerations and compared with changes during contractions with no alteration of heart rate.
SETTING
Teaching hospital obstetric unit.
SUBJECTS
Ten women in labour at term.
RESULTS
The changes in fetal cerebral oxyhaemoglobin and deoxyhaemoglobin concentrations that occurred during contractions were quantitatively similar, irrespective of the fetal heart rate changes. However, late fetal heart rate decelerations were associated with a significantly greater fall, after the uterine contraction, in the mean concentration of fetal cerebral oxyhaemoglobin of 0.52 mumol/100 g (SD 0.25) (P < 0.001) and a significantly greater rise in the mean concentration of deoxyhaemoglobin of 0.36 mumol/100 g (SD 0.35) (P < 0.01).
CONCLUSION
Late fetal heart rate decelerations are associated with a significant decrease in cerebral oxygenation.
目的
验证晚期胎儿心率减速与脑氧合作用降低相关这一假说。
设计
运用近红外光谱法，在伴有晚期胎儿心率减速的宫缩前、宫缩期间及宫缩后，测量胎儿大脑中氧合血红蛋白和脱氧血红蛋白的浓度变化，并与心率无变化的宫缩期间的变化进行比较。
地点
教学医院产科病房。
研究对象
10名足月分娩的女性。
结果
无论胎儿心率如何变化，宫缩期间胎儿大脑中氧合血红蛋白和脱氧血红蛋白浓度的变化在数量上是相似的。然而，晚期胎儿心率减速与宫缩后胎儿大脑氧合血红蛋白平均浓度显著下降0.52微摩尔/100克（标准差0.25）（P<0.001）以及脱氧血红蛋白平均浓度显著上升0.36微摩尔/100克（标准差0.35）（P<0.01）相关。
结论
晚期胎儿心率减速与脑氧合作用显著降低相关。
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