Arduini D, Rizzo G, Garzetti G G, Romanini C
Department of Obstetrics and Gynecology, University of Ancona, Italy.
Biol Neonate. 1993;63(6):341-8. doi: 10.1159/000243953.
We previously demonstrated a prognostic significance of maternal oxygen test in predicting imminent fetal distress. The purpose of this study was to investigate eventual other factors related to the length of the time interval elapsing between the Doppler diagnosis of brain sparing effect and abnormal fetal heart rate patterns. To this end we considered 101 growth-retarded fetuses free of structural and chromosomal abnormalities with a ratio between the pulsatility indices of umbilical and middle cerebral artery above the 95th centile in presence of a normal fetal heart rate pattern. The factors, other than the oxygen test, analyzed for a potential influence on this time interval were gestational age, presence of hypertension or preeclampsia, amniotic fluid index, severity of growth retardation (centile of the ultrasonographic estimated fetal weight) and 9 different Doppler indices calculated from extra- and intracardiac districts. Statistical actuarial methods were used to determine the effect of these prognostic factors on the duration of this time interval. The occurrence of abnormal fetal heart rate patterns (antepartum late heart rate decelerations) was used as censoring variable. The time interval between the entry in the study and delivery ranged from 1 to 39 days. Indications for delivery were fetal distress in 53 fetuses (52.4%) and different maternal or fetal complications in the remaining 48 fetuses.(ABSTRACT TRUNCATED AT 250 WORDS)
我们之前已证明母体氧试验在预测即将发生的胎儿窘迫方面具有预后意义。本研究的目的是调查与脑保护效应的多普勒诊断和异常胎儿心率模式之间的时间间隔长短相关的其他可能因素。为此，我们纳入了101例生长受限胎儿，这些胎儿无结构和染色体异常，在胎儿心率模式正常的情况下，脐动脉与大脑中动脉搏动指数之比高于第95百分位数。除氧试验外，分析的可能影响该时间间隔的因素包括孕周、高血压或先兆子痫的存在、羊水指数、生长受限的严重程度（超声估计胎儿体重的百分位数）以及从心脏外和心脏内区域计算出的9种不同的多普勒指数。采用统计精算方法来确定这些预后因素对该时间间隔持续时间的影响。将异常胎儿心率模式（产前晚期心率减速）的发生用作删失变量。从进入研究到分娩的时间间隔为1至39天。53例胎儿（52.4%）因胎儿窘迫而分娩，其余48例胎儿因不同的母体或胎儿并发症而分娩。（摘要截短于250字）
