Carbonne B, Audibert F, Segard L, Sebban E, Cabrol D, Papiernik E
Maternité Port-Royal-Baudelocque, Paris, France.
Eur J Obstet Gynecol Reprod Biol. 1994 Nov;57(2):73-7. doi: 10.1016/0028-2243(94)90046-9.
Arterial oxygen saturation of the fetus during labour (SPO2) measured with a fetal pulse oximeter was compared to the neonatal condition measured by umbilical vein pH and Apgar score. Changes in oxygen saturation (index of desaturation) during the second stage of labour were also compared to neonatal outcome. Fifty-five patients with abnormal fetal heart rate pattern during labour had a continuous monitoring of fetal oxygen saturation using the Nellcor N-400 pulse oximeter. SPO2 measurement during the last 10 min of labour was significantly correlated to umbilical vein pH and to 1-min Apgar score (P = 0.022 and P = 0.025, respectively). A much higher correlation was found between the index of desaturation and umbilical vein pH at birth and with 1-min Apgar score (P = 0.002 and P < 0.001, respectively). When considering the lower value of umbilical vein pH at birth to be 7.20, and the normal value of SPO2 during labour to be > or = 40% (negative test), we observed a 100% negative predictive value of oximetry. If these results are confirmed in a larger series of patients, analysis of the changes in fetal arterial oxygen saturation during labour (index of desaturation) could be a good indicator of the condition of the newborn. A normal SPO2 value during labour could be reassuring in case of abnormal fetal heart rate.
使用胎儿脉搏血氧仪测量分娩期间胎儿的动脉血氧饱和度（SPO2），并与通过脐静脉pH值和阿氏评分测量的新生儿状况进行比较。还将第二产程中血氧饱和度的变化（去饱和指数）与新生儿结局进行比较。55例分娩期间胎儿心率异常的患者使用Nellcor N - 400脉搏血氧仪持续监测胎儿血氧饱和度。分娩最后10分钟的SPO2测量值与脐静脉pH值和1分钟阿氏评分显著相关（分别为P = 0.022和P = 0.025）。出生时去饱和指数与脐静脉pH值以及1分钟阿氏评分之间的相关性更高（分别为P = 0.002和P < 0.001）。当将出生时脐静脉pH值的较低值设定为7.20，分娩期间SPO2的正常值设定为≥40%（阴性测试）时，我们观察到血氧测定的阴性预测值为100%。如果这些结果在更多患者中得到证实，分析分娩期间胎儿动脉血氧饱和度的变化（去饱和指数）可能是新生儿状况的良好指标。在胎儿心率异常的情况下，分娩期间正常的SPO2值可能令人安心。
