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Evaluation of fetal oxygen saturation (SpO_2) during labor and effects of maternal oxygen administration on fetal SpO_2

分娩时胎儿氧饱和度（SpO_2）的评估以及母体供氧对胎儿SpO_2的影响

基本信息

批准号：
05671395
负责人：
SATO Ikuo
金额：
$ 1.34万
依托单位：
Jichi Medical School
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (C)
财政年份：
1993
资助国家：
日本
起止时间：
1993 至 1994
项目状态：
已结题

项目摘要

The purposes of study were to develop a new reflectance pulse oximetry probe which enables us to measure fetal SpO_2 during labor continuously and non-invasively and to evaluate correlation between fetal heart rate (FHR) and fetal SpO_2. And effect of maternal oxygen administration to fetal SpO_2 was estimated.Patients and methods : 120 patients from 30 to 41 weeks were measured. The reflectance probe was adapted to the fetal forehead, on condition that uterine cervix was dilated more than 5cm with rupture of the bag with informed consent. Fetal SpO_2 and FHR was simultaneously monitored. Oxygen was administrated by a rate 5/min by nasal connula after obtained informed consent.Results : 1) The shoe-horn typed reflectance probe, 10mm between LED and sensor, was developed. 2) Good correlation between fetal SpO_2 just before birth and umbilical arterial blood SaO_2 was confirmed (y=0.97_X-7.28). 3) Fetal SpO_2 at cervical os 5-7cm dilated was 56<plus-minus>13%. SpO_2 at 8-9cm dilated was 60<plus-minus>11%. SpO_2 in second phase was 56<plus-minus>11%. SpO_2 just before birth was 48<plus-minus>13% and significantly lower than other stages. 4) Early deceleration did not decrease fetal SpO_2.5) Late deceleration and severe variable deceleration significantly decreased fetal SpO_2.6) Maternal oxygen administration to lower fetal baseline SpO_2 (50%) led to significant increase of fetal SpO2.Conclusion : 1) Fetal SpO_2 during labor remains above 55% and decreased below 50% just before birth. 2) Late deceleration and severe variable deceleration decrease fetal SpO_2.3) Maternal oygen administration is effective for hypoxic fetuses to increase SpO_2. Reflectance pulse oximetry may have potential to be a good tool in monitoring fetal wellbeing during labor.

本研究目的是研制一种新型反射式脉搏血氧探头，用于产程中无创连续监测胎儿SpO_2，并探讨胎儿心率与SpO_2的相关性。方法：对120例孕30 ~ 41周的孕妇进行SpO_2测定。在知情同意的情况下，如果宫颈扩张超过5cm且袋破裂，则将反射探头适配于胎儿前额。同时监测胎儿SpO_2和FHR。结果：1）研制了鞋拔式反射探头，探头与LED之间的距离为10 mm。2)胎儿出生前SpO_2与脐动脉SaO_2有良好的相关性（y=0.97_X-7.28）。3)胎儿宫颈口扩张5- 7 cm时SpO 2为<plus-minus>5613%。扩张8- 9 cm时SpO_2为<plus-minus>60.11%。第二时相SpO 2为<plus-minus>56.11%。临产时SpO_2为48.13%<plus-minus>，明显低于其他各期。4)5）晚期减速和重度可变减速均显著降低胎儿SpO 2。6）母体给氧至胎儿基础SpO 2低于50%时，胎儿SpO 2显著升高。结论：1）产程中胎儿SpO 2维持在55%以上，临产前降至50%以下。2)晚期减速和重度可变减速可降低胎儿SpO_2。3）母源性吸氧可有效提高缺氧胎儿SpO_2。反射式脉搏血氧仪可能是一个很好的工具，在监测胎儿的健康在劳动。