Begg L, East C, Chan F Y, Brennecke S
Department of Perinatal Medicine, Royal Women's Hospital, Melbourne.
Aust N Z J Obstet Gynaecol. 1998 Aug;38(3):271-4. doi: 10.1111/j.1479-828x.1998.tb03064.x.
Conventional intrapartum electronic fetal heart rate monitoring is not informative in certain fetal conditions because the electronically-monitored fetal heart rate pattern is uninterpretable in terms of reflecting fetal normoxia. Such fetal conditions include various cardiac dysrrhythmias and some central nervous system abnormalities. Difficulties with intrapartum fetal welfare surveillance in such conditions often lead to operative delivery as a precautionary measure. We report 2 cases of intrapartum fetal oxygen saturation monitoring in the presence of congenital complete heart block (CCHB), using the Nellcor N400/FS14 oxygen saturation monitoring system. Mean intrapartum fetal oxygen saturation (FSpO2) was 32% (SEM +/- 1%) in the first case and 48% (SEM +/- 0.3%) in the second case. In both cases, vaginal delivery of otherwise healthy infants was achieved. Fetal pulse oximetry is a promising new technique which directly measures fetal oxygenation without reference to fetal heart rate patterns. It may assist in the intrapartum fetal welfare assessment in conditions such as complete heart block, thereby helping to avoid otherwise unnecessary operative delivery.
传统的产时电子胎儿心率监测在某些胎儿情况下并无信息价值，因为从反映胎儿正常氧合的角度来看，电子监测的胎儿心率模式无法解读。此类胎儿情况包括各种心律失常和一些中枢神经系统异常。在此类情况下进行产时胎儿健康监测存在困难，这往往导致作为预防措施而进行手术分娩。我们报告了2例在先天性完全性心脏传导阻滞（CCHB）情况下进行产时胎儿氧饱和度监测的病例，使用的是Nellcor N400/FS14氧饱和度监测系统。第一例病例中产时胎儿平均氧饱和度（FSpO2）为32%（标准误±1%），第二例为48%（标准误±0.3%）。在这两例中，均实现了对健康婴儿的阴道分娩。胎儿脉搏血氧测定法是一项有前景的新技术，它直接测量胎儿氧合情况，而无需参考胎儿心率模式。它可能有助于在诸如完全性心脏传导阻滞等情况下进行产时胎儿健康评估，从而有助于避免原本不必要的手术分娩。
