Dildy G A, van den Berg P P, Katz M, Clark S L, Jongsma H W, Nijhuis J G, Loucks C A
Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City.
Am J Obstet Gynecol. 1994 Sep;171(3):679-84. doi: 10.1016/0002-9378(94)90081-7.
Our purpose was to study fetal arterial oxygen saturation trends by continuous pulse oximetry during labor in subjects with normal and abnormal delivery outcomes.
Continuous fetal arterial oxygen saturation was measured during labor with a noninvasive reflectance pulse oximeter designed for fetal application. Averaged arterial oxygen saturation values were compared between stage 1 and stage 2 of labor, with stage 1 further subdivided into early (< or = 4 cm), middle (5 to 7 cm), and late (8 to 10 cm) phases. Delivery outcome was considered to be abnormal for any of the following conditions: gestational age < 37 weeks, maternal oxygen administration, delivery by cesarean section, 5-minute Apgar score < 7, umbilical artery pH < 7.10, birth weight < 2500 gm, or newborn intensive care unit admission.
A total of 291 subjects were studied: 142 in Provo, 90 in Nijmegen and 59 in San Francisco. Subjects with delivery complications (n = 125) were evaluated separately from those with normal delivery outcomes (n = 160). Fetal arterial oxygen saturation was 58% +/- 10% (mean +/- SD) during the cumulative period of study for the normal-outcome group. A significant decrease (paired t test, p < 0.001) in fetal arterial oxygen saturation occurred from stage 1 (59% +/- 10%) to stage 2 (53% +/- 10%) labor. When stage 1 was subdivided into early (< or = 4 cm), middle (5 to 7 cm), and late (8 to 10 cm) phases, a gradual decreasing trend in fetal arterial oxygen saturation was observed: 62% +/- 9%, 60% +/- 11%, and 58% +/- 10%.
With the use of reflectance pulse oximetry, a statistically significant decrease in fetal arterial oxygen saturation was observed during labor in women with normal and abnormal delivery outcomes.
我们的目的是通过连续脉搏血氧饱和度测定法研究正常和异常分娩结局的产妇在分娩过程中胎儿动脉血氧饱和度的变化趋势。
在分娩过程中，使用专为胎儿设计的无创反射式脉搏血氧仪测量胎儿动脉血氧饱和度的连续值。比较第一产程和第二产程的平均动脉血氧饱和度值，第一产程进一步细分为早期（≤4厘米）、中期（5至7厘米）和晚期（8至10厘米）阶段。以下任何一种情况的分娩结局被视为异常：孕周<37周、产妇吸氧、剖宫产、5分钟Apgar评分<7、脐动脉pH<7.10、出生体重<2500克或新生儿入住重症监护病房。
共研究了291名受试者：普罗沃142名、奈梅亨90名、旧金山59名。分娩并发症患者（n = 125）与分娩结局正常的患者（n = 160）分开评估。正常结局组在研究累积期间胎儿动脉血氧饱和度为58%±10%（平均值±标准差）。从第一产程（59%±10%）到第二产程（53%±10%），胎儿动脉血氧饱和度出现显著下降（配对t检验，p<0.001）。当第一产程细分为早期（≤4厘米）、中期（5至7厘米）和晚期（8至10厘米）阶段时，观察到胎儿动脉血氧饱和度呈逐渐下降趋势：62%±9%、60%±11%和58%±10%。
使用反射式脉搏血氧饱和度测定法观察到，正常和异常分娩结局的产妇在分娩过程中胎儿动脉血氧饱和度均有统计学意义的下降。
