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태아 생물리학적 계수와 제대혈가스분석과의 관련성에 관한 연구

Relationship between Fetal Biophysical Profile Score, Individual Biophysical Activities and Umbilical Cord Blood Acid-Base and Gas Values

대한산부인과학회지 1993년 36권 12호 p.3844 ~ 3856
소속 상세정보
박교훈 윤보현/전종관/이철민/진호준/신희철/김승욱

Abstract


A strong correlation between the fetal biophysical profile and umbilical cord blood pH has already been reported. However the relationship between fetal biophysical profile and remaing umbilical blood gas values, including Pco2, Po2, HCO3, has
not
been
reproted. Threrefore the relationship between fetal biophysical profile and umbilical cord blood acidbase and gas values were assessed in 206 singleton pregnancies in which cesarean section was performed before onset of labor. In all cases fetal
biophysical profile assessment was performed within 16 hours before cesarean section. Immediately after delivery, umbilical arterial blood gas analysis was performed in 149 patients and umbilical venous blood analysis in 146 patients. The
presence
ofr
absence of the individual fetal biophysical activities (fetal heart rate reactivity, fetal breathing movement , fetal body movement, and fetal tone) and biophysical score were correlated with umbilical cord blood gas analysis, especially pH,
Pco2,
HCO3
(artery). Fetuses with nonreactive nonstress test results or the absence of breathing or absence of movement had significantly lower cord artery pH, HCO3, and significantly higher Pco2 concentration than did those with reactive nonstress test
results or
the presence of breathing or the presene of movement. However there was no significant difference in Po2 concentration between these two groups of fetuses, i.e., nonreactive and reactive nonstress test, presence and absence of breathing, presence
and
absence of movement, respectively. Fetuses with the absence of bone had significantly lower core artery pH, HCO3 than did those with the presence of tone, However there were no differences in the Po2 Pco2 concentration between these two groups of
fetuses. Fetuses with abnormal biophysical score, as defined by a score of ≤6, had significantly lower cord artery pH, HCO3 and significantly higher Pco2 concentration than did those with normal biophysical score, as defined by a score of≥8.
The
individual fetal biophysical activities and biophysical score are sensitive indicator of fetal acidosis and hypercapnea, but not that of fetal hypoxemia. The relationship between the pH, Pco2 and the results of nonstress test,k fetal breathing
movement,
fetal body movement, and fetal tone suggested that the first manifestations of fetal acidosis and hypercdapnea were nonreactive nonstress test results and loss of fetal breathing and in advanced acidosis and hypercapnea, fetal movements and fetal
tone
were compromised. But there were no different degrees of fetal hypoxemia at which the biophysical activities were compromised.

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