van den Berg P P, Nijland R, van den Brand S F, Jongsma H W, Nijhuis J G
Department of Obstetrics and Gynecology, University Hospital Nijmegen, The Netherlands.
Obstet Gynecol. 1994 Oct;84(4 Pt 2):683-6.
In cases of fetal congenital heart block, the fetal heart rate (FHR) pattern is uninterpretable, often leading to an operative delivery. Reflectance pulse oximetry, a new technique that continuously measures the fetal arterial oxygen saturation (SaO2) during labor, is potentially useful in intrapartum monitoring of fetuses with this condition.
Two fetuses with congenital heart block were monitored with reflectance pulse oximetry and fetal scalp blood sampling. The first patient delivered spontaneously. Adequate signal quality was achieved during 73% of the study time. Mean +/- standard deviation (SD) SaO2 was 53 +/- 14%. Fetal outcome was good. The second patient was delivered by cesarean because of arrest of labor. Oxygen saturation values were obtained during 89% of the study time. The mean SaO2 was 42 +/- 13%. There was a period of 8 minutes with SaO2 values below 20%. Capillary blood pH dropped from 7.33 to 7.25; SaO2 values then returned to levels above 30% and the capillary blood pH normalized. The neonate was born in good condition.
In fetal congenital heart block, adequate surveillance with FHR monitoring during labor is not possible; therefore, continuous information on fetal oxygenation may be valuable in assessing the fetal condition and may prevent unnecessary obstetric interventions.
在胎儿先天性心脏传导阻滞的病例中，胎儿心率（FHR）模式无法解读，常常导致手术分娩。反射式脉搏血氧饱和度测定法是一种在分娩期间连续测量胎儿动脉血氧饱和度（SaO2）的新技术，在对患有这种疾病的胎儿进行产时监测方面可能有用。
对两名患有先天性心脏传导阻滞的胎儿进行了反射式脉搏血氧饱和度测定法和胎儿头皮血采样监测。第一名患者自然分娩。在73%的研究时间内获得了足够的信号质量。平均±标准差（SD）SaO2为53±14%。胎儿结局良好。第二名患者因产程停滞而行剖宫产。在89%的研究时间内获得了血氧饱和度值。平均SaO2为42±13%。有一段8分钟的时间SaO2值低于20%。毛细血管血pH值从7.33降至7.25；随后SaO2值恢复到30%以上，毛细血管血pH值恢复正常。新生儿出生时状况良好。
在胎儿先天性心脏传导阻滞中，分娩期间无法通过FHR监测进行充分的监测；因此，关于胎儿氧合的连续信息在评估胎儿状况方面可能有价值，并可能避免不必要的产科干预。
