ST analysis of the fetal electrocardiogram during labor: Nordic observational multicenter study.
ST analysis of the fetal electrocardiogram during labor: Nordic observational multicenter study.
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DOI：
10.1080/713605678
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发表时间：
2002-10-01
期刊：
影响因子：
--
通讯作者：
Rosen, K G
中科院分区：
文献类型：
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作者：
Amer-Wahlin, I;Bordahl, P;Rosen, K G
目的：评估心宫缩监护 (CTG) 加上心电图 (ECG) 临床指南中的 ST 间期，结合胎儿心率和临产期间记录的胎儿心电图 ST 波形分析的诊断能力，以确定不良临产结局（新生儿神经系统症状和/或代谢性酸中毒）。 研究设计：在 12 个北欧产房进行了一项观察性多中心研究。使用带有胎儿心电图数据和计算机 ST 分析的 STAN S 21 记录仪原型对总共 573 名临产妇女进行监测。 结果：记录了 15 例产时胎儿缺氧的病例，这些病例是根据神经新生儿症状和/或脐带动脉 pH < 7.05 且细胞外液碱不足 > 12.0 mmol/l 确定的。所有这些病例均根据 CTG + ST 临床指南进行鉴定。 5 名在第一产程期间出现新生儿症状并出现心电图异常，其余 10 名中的 8 名在第二产程主动用力期间出现 ST 变化。另外八例仅出现酸血症，新生儿结局正常。其中 7 例显示 CTG + ST 异常。与传统 CTG 相比，CTG + ST 预测胎儿酸中毒的高灵敏度与阳性预测值显着增加相关。结论：STAN 临床指南识别出胎儿有产时窒息的风险。
OBJECTIVE: To assess the diagnostic power of cardiotocography (CTG) plus the ST interval of the electrocardiogram (ECG) clinical guidelines with combined fetal heart rate and ST waveform analysis of the fetal ECG recorded during labor, to identify an adverse labor outcome (neonatal neurological symptoms and/or metabolic acidosis).STUDY DESIGN: An observational, multicenter study was undertaken in 12 Nordic labor wards. A total of 573 women in labor were monitored using a prototype of the STAN S 21 recorder with fetal ECG data and computerized ST analysis.RESULTS: Fifteen cases of intrapartum fetal hypoxia identified from neurological neonatal symptoms and/or cord artery pH < 7.05 with base deficit in extracellular fluid > 12.0 mmol/l were recorded. All these cases were identified by CTG + ST clinical guidelines. Five developed neonatal symptoms and had ECG abnormalities during the first stage of labor and, of the remaining ten, eight showed ST changes during active pushing in the second stage. Another eight cases had acidemia only and normal neonatal outcome. Seven of these displayed CTG + ST abnormalities. The high sensitivity of CTG + ST to predict fetal acidosis was associated with a marked increase in positive predictive values compared with conventional CTG.CONCLUSION: The STAN clinical guidelines identify fetuses at risk of intrapartum asphyxia.