INTRAPARTUM FETAL HEART-RATE MONITORING .8. ATYPICAL VARIABLE DECELERATIONS
INTRAPARTUM FETAL HEART-RATE MONITORING .8. ATYPICAL VARIABLE DECELERATIONS
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DOI：
10.1016/0002-9378(83)90714-7
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发表时间：
1983-01-01
影响因子：
9.8
通讯作者：
DUNN, LJ
中科院分区：
文献类型：
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作者：
KREBS, HB;PETRES, RE;DUNN, LJ
对1996例胎儿心率(FHR)轨迹进行了分析，以评估可变减速的预后意义。在监测的988例产程最后30分钟内有不同减速的胎心轨迹中，19%(186例)出现异型性迹象，按频率顺序排列：初始加速度丧失；缓慢恢复到基线FHR；次级加速丧失；延长次级加速；双相减速；减速过程中变异性丧失；基线持续在较低水平。使用.gtoreq进行可变减速。其中1个特征被称为非典型变异性减速，并预示着胎儿酸中毒的高发生率和低阿普加评分。对于纯可变减速(P<；<；0.001)，无论减速的持续时间和幅度如何，不良的胎儿结局都不常见。在60%的病例中，单纯和非典型变异性减速与其他胎心率异常相关。FHR变异性降低和心动过速或心动过缓尤其不利的组合在不典型减速组比单纯变异性减速组更常见(P<；<；0.001)，并预测低阿普加评分的发生率最高。非典型征象对诊断可变减速胎儿窘迫有很大帮助。
A total of 1996 [human] fetal heart rate (FHR) tracings were analyzed to assess the prognostic significance of variable decelerations. Of 988 tracings with variable decelerations in the last 30 min of monitored labor, 19% (186 cases) exhibited signs of atypia, listed in order of frequency: loss of initial acceleration; slow return to the baseline FHR; loss of secondary acceleration; prolonged secondary acceleration; biphasic deceleration; loss of variability during deceleration; and continuation of the baseline at a lower level. Variable decelerations with .gtoreq. 1 of these features were called atypical variable decelerations and predicted a high incidence of fetal acidosis and low Apgar scores. Adverse fetal outcome was uncommon with pure variable decelerations (P < < 0.001) irrespective of the duration and amplitude of the deceleration. Pure and atypical variable decelerations were associated with other FHR abnormalities in > 60% of the cases. The particularly unfavorable combination with decreased FHR variability and tachycardia or bradycardia was seen more frequently with atypical than with pure variable decelerations (P < < 0.001) and predicted the highest incidence of low Apgar scores. Atypical features aid greatly in the identification of distress in fetuses with variable decelerations.