1982년 6월부터 7월까지 이화 대학병원 산부인과에 입원 분만한 총 449명중 임부 82예를 대상으로 진통중 직접태아심박감시 및 태아두피혈 pH 검사를 반복 실시하고, 양수의 태변착색 유무를 관찰하여 태아장애 및 예후에 대한 다음과 같은 결과를 얻었다. 1. 무주기변화(no periodic change), 심박상승(acceleration) 및 조기하강(early deceleration), 예에서는 태아장애(Apgar 점수 6점이하) 및 산혈증(acidotic)이 거의 없었으나 (10% 미만), 변이하강(variable deceleration) 형에서는 태아장애가 25%, 산혈증 및 전산혈증(preacidotic)이 51%였다. 2. 두피혈 pH가 <9.20≤7.25인 전산혈증이며 변이하강혈이 나타날때는 변이하강의 심한 정도에 따라 차이가 없어 33%의 태아장애가 나타났으나, 두피혈 pH가 7.20 이하이면서 경한 변이하강형에서는 태아장애 빈도가 40%, 중등도 및 심한 변이하강군에서는 100%의 태아장애를 보였다. 3. 태아예후와 변이지수(variability index)와의 관계는 변이하강형이 나타나며 변이지수가 4이하인 경우에는 태아장애 빈도가 높았고(63%) 변이지수가 5이상에서는 20%로 태아장애 빈도가 감소되었으며, 무주기변화, 심박상승 및 조기하강형으로 나타났을 때는 태아상태가 변이지수의 증감에 관계없이 양호하였다. 4. 태아두피혈 pH가 7.25 이하의 산혈증 및 전산혈증을 나타낸 예에서는 33%∼55%의 태아장애를 보였고, 불길한 태아심박형(ominous fetal heart rate pattern), 낮은 변이지수(≤4) 및 양수의 태변착색의 발생빈도는 태아두피혈이 낮을수록 높아졌다. 5. 고위험임산부에서 태아심박형, 태아심박동변이 및 태아두피혈 pH등을 동시 관찰하여 태아예후를 비교적 정확하게 예측하였고, 양수의 태변착색도 좋은 지칭이 되었다.

Accurate assessment fetal condition during labor is constituted to be very important mdern Obstetrics. For practical purposes, following methods were offered as promising approaches to this obstetrics problem; there are continuous monitoring of fetal heart rate patterns and fetal heart rate variabilities, repeated checking fetal scalp blood pH and observation of meconium stained amniotic fluid. Prediction of the fetal outcom was obtained from 82 pregnant patients at Obstetric and Gynecologic department of Ewha Womans University from June to July, 1982. The results were as follows; 1. The incidence of fetal distress with lower Apgar score(≤6) or acidotic condition was very few (less than 10%) in cases with no periodic changes accelearation or early deceleration patterns appeared, but the higher indicence was occurred in cases with variable deceleration pattern appeared (51% of acidotic and preacidotic condition or 25% of low Apgar score, 6 or less). 2. When the fetal blood pH lowered to the level of <7.20≤7.25(preacidotic) the incidence of fetal distress with lower Apgar score(≤6) was farely high (33%) regardless the type of variable deceleration pattern associated. More over, when the blood PH down to the acidotic level(≤7.20) associated with moderate or severe variable deceleration pattern showed all of the cases(100%) developed fetal distress with lower Apgar score(≤6). 3. The higher incidence(63%) of fetal distress (Apgar score≤6) were found in the cases with lower variability indices(≤4) associated with variable deceleration pattern. However, the lower incidence(14∼24%) of fetal distress resulted in when 5 or more variability indices associated with variable deceleration pattern appeared. 4. When the fetal blood pH lowered to the level of 7.25 or below (acidotic or preacidotic), incidence of fetal distress with lower Apgar score(≤6) were 33% or 55% and it was higher than 4 or 7 times the normal blood pH subjects(≥7.25). The lower blood pH level was usually associated with the higher frequency of ominous fetal heart rate pattern, lower variability indices(≤4) and meconium stained amniotic fluid. 5. The prediction of fetal distress in the high risk pregnancy was best acomplished by fetal heart rate pattern plus fetal scalp blood pH level and the picture of meconium stained amniotic fluid also cannot overlook.