母体心拍数の周波数解析により抽出された変動成分に基づく分娩進行情報
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概要
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The author measured the maternal heart rate (MHR), blood pressure, deep body temperature, fetal movement (FM) and either the intra or extra uterine contraction (UC). The measurements were taken using normal procedures. A nonstress test (NST) or a contraction stress test (CST) were recorded for 17 nulliparas and 6 multiparas before labor and in labor 28 primiparas and 43 multiparas. In the progress of pregnancy and labor, MHR variation during FM and UC were examined, and the frequency of MHR variation that correlated with FM and UC were analyzed by fast Fourier transform (FFT) and abstracted. The variation cycle and amplitude of abstracted waves were converted into time series data (full-wave rectification) as a UC curve for clinical appli-cation and these data were recognized as practical and objective information of gestation and labor progress. The results are summarized as follows : 1) In cases of NST from about 30 weeks gestation, characteristic MHR variation waves were obser- ved, which were approximately the same as the fluctuation component of blood pressure and breathing, coming before and after the FM curve and extra UC curve. The range of variation increased slowly, then decreased from about 35 to 37 weeks gestation, and then also increased for delivery. 2) The MHR patterns on labor progress at the time of a UC were classified into three types (descent, broad line, and ascent). By use of these patterns, the degree of labor progress was recognized generously in 14/15 (93%) of the primiparas and in 16/21 (76%) of the multiparas, and characteristic MHR variation disappeared thirty minutes after delivery. 3) When MHR and UC were analyzed by FFT, the component waves were similar in the low band, and the 0.01Hz harmonic component of MHR increased and decreased depending on the time of gestation. The regressive equation for day of onset of labor was determined using power spec- trum levels and days before delivery for parameters. High correlations were obtained in nul- lipara r =0.83, p<0.05 and in multipara r=0.94, p<0.05. It was recognized that the 0.01Hz har- monic component of MHR was efficient for providing information of gestation and labor prog- ress. 4) When the waves of 0.01 Hz harmonic component were abstracted and converted into full-wave rectification data, it was recognized that onset of labor occurred after the 0.01 Hz component level moved higher than the 0.03 Hz level and the 0.01 Hz component waves had become period- ical. As labor progressed, the 0.01 Hz component level increased gradually and became higher than the 0.02Hz and 0.03Hz level.
- 札幌医科大学の論文
- 1991-04-01
札幌医科大学 | 論文
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