Understanding Fetal Heart Rate Patterns That May Predict Antenatal and Intrapartum Neural Injury

Christopher A. Lear, Jenny A. Westgate, Austin Ugwumadu, Jan G. Nijhuis, Peter R. Stone, Antoniya Georgieva, Tomoaki Ikeda, Guido Wassink , Laura Bennet , Alistair J. Gunn Seminars in Pediatric Neurology Volume 28, December 2018, Pages 3–16

Electronic fetal heart rate (FHR) monitoring is widely used to assess fetal well-being throughout pregnancy and labor. Both antenatal and intrapartum FHR monitoring are associated with a high negative predictive value and a very poor positive predictive value. This in part reflects the physiological resilience of the healthy fetus and the remarkable effectiveness of fetal adaptations to even severe challenges. In this way, the majority of “abnormal” FHR patterns in fact reflect a fetus' appropriate adaptive responses to adverse in utero conditions. Understanding the physiology of these adaptations, how they are reflected in the FHR trace and in what conditions they can fail is therefore critical to appreciating both the potential uses and limitations of electronic FHR monitoring.

中文翻译：

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我们对健康和疾病中胎儿心率模式的理解更新

了解可预测产前和产时神经损伤的胎心率模式

Christopher A. Lear、Jenny A. Westgate、Austin Ugwumadu、Jan G. Nijhuis、Peter R. Stone、Antoniya Georgieva、Tomoaki Ikeda、Guido Wassink、Laura Bennet、Alistair J. Gunn 小儿神经病学研讨会第 28 卷，2018 年 12 月，页数3–16

电子胎心率 (FHR) 监测广泛用于评估整个怀孕和分娩过程中胎儿的健康状况。产前和产时胎心率监测均具有较高的阴性预测值和非常差的阳性预测值。这在一定程度上反映了健康胎儿的生理弹性以及胎儿适应严峻挑战的显着效果。这样，大多数“异常”胎心率模式实际上反映了胎儿对子宫内不利条件的适当适应性反应。因此，了解这些适应的生理学、它们如何在胎心率轨迹中反映出来以及它们在什么条件下可能会失败对于了解电子胎心率监测的潜在用途和局限性至关重要。