Low J A, Panagiotopoulos C, Derrick E J
Department of Obstetrics and Gynecology, Queen's University, Kingston, Ontario, Canada.
Am J Obstet Gynecol. 1994 Apr;170(4):1081-7. doi: 10.1016/s0002-9378(94)70101-6.
Our purpose was to determine the newborn complications after respiratory or metabolic acidosis at delivery and to demonstrate the characteristics of an asphyxial insult predictive of these complications.
Fifty-nine term fetuses with metabolic acidosis were matched with 59 fetuses with normal blood gas measures at delivery. Fifty-one fetuses with respiratory acidosis were also examined. A complication score expressed the magnitude of newborn complications during the 10 days after delivery.
Newborn complications were not increased after respiratory acidosis. Newborn complications after metabolic acidosis increase in frequency and severity with the increasing severity and duration of the metabolic acidosis. Thirty-two of the 59 newborns in the metabolic acidosis group had a high complication score. The index values predictive of high scores were the duration of the metabolic acidosis and the Apgar score at 1 minute.
Intrapartum fetal asphyxia with a severe metabolic acidosis accounts for complications in all newborn systems. The probability of a high complication score increases from 14% with favorable index values to 85% with unfavorable index values.
我们的目的是确定分娩时呼吸性或代谢性酸中毒后的新生儿并发症，并阐明预测这些并发症的窒息性损伤特征。
59例患有代谢性酸中毒的足月儿与59例分娩时血气指标正常的胎儿进行匹配。还对51例患有呼吸性酸中毒的胎儿进行了检查。并发症评分表示分娩后10天内新生儿并发症的严重程度。
呼吸性酸中毒后新生儿并发症并未增加。代谢性酸中毒后的新生儿并发症的发生频率和严重程度随着代谢性酸中毒严重程度和持续时间的增加而增加。代谢性酸中毒组的59例新生儿中有32例并发症评分较高。预测高分的指标值是代谢性酸中毒的持续时间和1分钟时的阿氏评分。
伴有严重代谢性酸中毒的产时胎儿窒息是所有新生儿系统并发症的原因。并发症评分高的概率从指标值良好时的14%增加到指标值不良时的85%。
