Amano K, Hirano S, Nishijima M
Department of Obstetrics and Gynecology, Kitasato University, School of Medicine, Kanagawa, Japan.
Nihon Sanka Fujinka Gakkai Zasshi. 1996 Feb;48(2):96-102.
The significance of fetal arterial oxygen saturation (SpO2) monitoring and its relationship with FHR patterns were studied. Continuous fetal SpO2 was obtained by infrared pulse oximetry (Nellcor N-400) in 76 cases. After amniotomy, a reflectance fetal oximetry sensor (Nellcor FS-10) was placed onto the fetal cheek. The relationship between SpO2 and FHR pattern was then studied and the following results were obtained. 1. Mean recording time was 218 min. and satisfactory records were obtained during 75% of that time. 2. Whenever the FHR was reassuring, the range of SpO2 was stable within 40-80%. 3. Variations in SpO2 values were noted during decelerative patterns. When the FHR was not reassuring, the SpO2 value tended to be lower than 40%. A more acidotic tendency was found in cases where SpO2 was below 40% prior to delivery (umbilical arterial pH 7.135 +/- 0.100 vs 7.282 +/- 0.047, p < 0.005). 4. In cases of fetal arrhythmia (congenital complete heart block 3, supra ventricular tachycardia 1), SpO2 monitoring seemed to be an effective tool for fetal surveillance during labor. Fetal SpO2 measurement seemed to be an alternative to scalp blood sampling and is especially effective in cases with a nonreassuring or uninterpretable FHR pattern such as fetal arrhythmia.
研究了胎儿动脉血氧饱和度（SpO2）监测的意义及其与胎心监护图形的关系。采用红外脉搏血氧饱和度仪（Nellcor N - 400）对76例孕妇进行连续胎儿SpO2监测。破膜后，将反射式胎儿血氧饱和度传感器（Nellcor FS - 10）置于胎儿脸颊。然后研究SpO2与胎心监护图形的关系，得出以下结果：1. 平均记录时间为218分钟，其中75%的时间获得了满意的记录。2. 只要胎心监护结果良好，SpO2范围稳定在40% - 80%之间。3. 在减速图形期间注意到SpO2值的变化。当胎心监护结果不良时，SpO2值往往低于40%。分娩前SpO2低于40%的病例中发现有更明显的酸中毒倾向（脐动脉pH值7.135±0.100 vs 7.282±0.047，p < 0.005）。4. 在胎儿心律失常（先天性完全性心脏传导阻滞3例，室上性心动过速1例）的病例中，SpO2监测似乎是产时胎儿监护的有效工具。胎儿SpO2测量似乎是头皮血采样的替代方法，在胎心监护结果不良或难以解读的情况如胎儿心律失常时尤其有效。
