Evaluation of fetal blood pressure changes during intrapartum period : basic and clinical researches

背景资料：从我们以前的研究中，我们发现，胎儿的机电差异是可逆的血压变化在utero.Materials和方法：IRB批准后，我们介绍了这项技术的临床实践，以不断评估胎儿血压变化在劳动和交付。知情同意后，从18位母亲，我们放置了一个电极在头皮上的胎儿心电图和一个SpO2探头的脸颊，破膜后。在分娩过程中没有技术相关的异常。所有婴儿的脐动脉pH值> 7.2，神经功能正常。15例监测时间大于或等于1 h的病例中，7例时间差缩短，2例时间差延长，6例时间差稳定。缩短组和稳定组相比，发生率严重可变减速显着增加缩短组，这表明反映的儿茶酚胺释放可能导致血压increases.Conclusions：这些研究结果表明，这项技术是有前途的，实际上适用于临床使用，以补充胎儿心率监测，以减少假阳性率的非放心胎儿状态。

Background : From our previous studies, we found that electro-mechanical difference in the fetus is reciprocal to blood pressure changes in utero.Materials and methods : After IRB approval, we introduced this technique to clinical practice to continuously evaluate fetal blood pressure changes during labor and delivery. After informed consent was obtained from each of the 18 mothers, we placed an electrode on the scalp for fetal electrocardiogram and a SpO2 probe on the cheek, after rupture of the membranes.Results : Electro-mechanical difference was available in all cases. There was no technique-related abnormality in the conduction of labor. All infants had umbilical arterial pH values > 7.2 and normal neurological outcome. Among the 15 cases with 1-hour or more monitoring duration, the time difference became shortening in 7 cases, extending in 2, and stable in 6. Comparing the shortening and stable groups, incidence of severe variable deceleration was significantly increased in the shortening group, suggesting the reflection of catecholamine release leading possibly to blood pressure increases.Conclusions : These findings suggest that this technique is promising and practically applicable to clinical use to supplement fetal heart rate monitoring such that to decrease false positive rate of non-reassuring fetal status.