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

背景：我们从以往的研究中发现，胎儿的机电差异与宫内血压的变化是相互作用的。材料和方法：在IRB批准后，我们将这项技术引入临床实践，以连续评估分娩期间胎儿血压的变化。在征得18位母亲的知情同意后，在胎膜破裂后，在头皮上放置胎儿心电电极，在脸颊上放置SpO2探头。产程中未发现与技术有关的异常。所有婴儿的脐动脉pH值均为7.2，神经学结果正常。15例监护1小时以上的患者，时差缩短7例，延长2例，稳定6例。与缩短组和稳定组相比，缩短组重度变异性减速发生率明显增加，提示儿茶酚胺释放反映可能导致血压升高。结论：该技术可作为胎心监护的补充，降低不能令人放心的胎儿状态的假阳性率，具有实用价值。

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.