ST analysis of fetal electrocardiography in labor
ST analysis of fetal electrocardiography in labor
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DOI：
10.1016/j.siny.2010.09.004
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发表时间：
2011-02-01
影响因子：
3
通讯作者：
Marsal, K.
中科院分区：
文献类型：
--
作者：
Amer-Wahlin, I.;Marsal, K.
自40多年前引入以来，电子胎儿监测已被广泛用于产前监视，以确定劳动胎儿健康。尽管胎儿缺氧和酸中毒反映在胎儿心率的变化中，但尚无证据表明心脏造影已经有效地降低了与劳动期间发生的与胎儿困扰有关的新生儿发病率。实际上，该工具的特异性很差，在许多情况下，将电子胎儿监测纳入产前护理仅导致医疗干预的增加，而不是改善新生儿结果。胎儿心电图（ECG）分析提供了一种评估胎儿对缺氧的反应，尤其是对代谢性酸中毒的发展的其他方法。可以通过计算分析来量化胎儿心电图的ST变化，从而减少了传统电子胎儿监测问题的主观解释。已经设计了指示干预劳动力的适当观点的正式算法。在几项随机对照试验中，胎儿心电图已被证明是传统电子胎儿监测的有用辅助手段，证明了新生儿脑病率降低和产科干预率降低。 （c）2010 Elsevier Ltd.保留所有权利。
Since its introduction more than 40 years ago, electronic fetal monitoring has become widely used for intrapartum surveillance to determine fetal wellbeing in labor. Although fetal hypoxia and acidosis are reflected in changes in fetal heart rate, there is no evidence that cardiotocography has been effective in reducing neonatal morbidity related to fetal distress occurring during labor. Indeed the specificity of this tool is poor and in many instances the incorporation of electronic fetal monitoring into intrapartum care has merely led to an increase in medical intervention rather than an improvement in neonatal outcome. Fetal electrocardiography (ECG) analysis provides an additional method for assessing the response of the fetus to hypoxia and in particular to the development of metabolic acidosis. ST changes in the fetal ECG can be quantified with computational analysis, reducing subjective interpretation that has been problematic with traditional electronic fetal monitoring. Formal algorithms indicating appropriate points for intervention in labor have been designed. The fetal ECG has been shown to be a useful adjunct to traditional electronic fetal monitoring in several randomized controlled trials with evidence of reduced rates of neonatal encephalopathy and reduced rates of obstetric intervention. (C) 2010 Elsevier Ltd. All rights reserved.