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首页> 外文期刊>BJOG: an international journal of obstetrics and gynaecology >Limitations of ST analysis in clinical practice: three cases of intrapartum metabolic acidosis.
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Limitations of ST analysis in clinical practice: three cases of intrapartum metabolic acidosis.

机译：ST分析在临床实践中的局限性：3例宫内代谢性酸中毒。

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OBJECTIVE: To examine detailed intrapartum events in cases of neonatal metabolic acidosis despite monitoring using STAN (cardiotocography [CTG] plus ST waveform analysis of fetal electrocardiogram [ECG]). DESIGN: Retrospective case review. SETTING: High-risk pregnancies monitored by STAN. METHODS: Case note review was performed in newborns with metabolic acidosis where no significant ST changes in the fetal ECG occurred prior to birth. MAIN OUTCOME MEASURES: Metabolic acidosis. RESULTS: Detailed review of three cases identified poor signal quality, difficulties in CTG interpretation, failure to comply with STAN clinical guidelines and deterioration of the CTG without ECG alert as the leading causes of these adverse outcomes. CONCLUSIONS: The cases illustrate some of the pitfalls associated with the clinical application of the STAN technology which prevent severe metabolic acidosis being eradicated completely. It may be useful to expand the STAN guidelines protocol towards the identification of exceptional clinical situations, such as in our cases, and towards appropriate additional interventions, as this may lead to a further reduction in adverse neonatal outcomes.
机译：目的：尽管使用STAN（心电图[CTG]加上胎儿心电图[ECG]的ST波形分析）进行监测，但仍要检查新生儿代谢性酸中毒的详细产时事件。设计：回顾性病例审查。地点：由STAN监控的高危妊娠。方法：对患有代谢性酸中毒的新生儿进行病例记录复查，这些胎儿出生前胎儿心电图没有明显的ST改变。主要观察指标：代谢性酸中毒。结果：对三例病例的详细检查发现信号质量差，CTG解释困难，未能遵守STAN临床指南以及没有ECG警报的CTG恶化是这些不良后果的主要原因。结论：这些病例说明了与STAN技术的临床应用相关的一些陷阱，这些陷阱可以防止严重的代谢性酸中毒完全消除。将STAN指南方案扩展到识别异常的临床情况（例如在我们的病例中）和进行适当的附加干预可能会很有用，因为这可能会导致新生儿不良结局的进一步减少。

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