Surgery – Truss – Pad
Patent
1995-04-21
1998-05-05
Nasser, Robert L.
Surgery
Truss
Pad
128687, 128677, 128748, A61B 504
Patent
active
057462127
DESCRIPTION:
BRIEF SUMMARY
FIELD OF THE INVENTION
The invention relates to a process and a device for measuring vital fetal parameters during labor and delivery.
BACKGROUND OF THE INVENTION
So far, a device for carrying out the so-called cardiotocography (CTG) has mainly been used in practice in obstetrics.
The child's heart rate and the mother's labor are represented in two recording tracks in a side-by-side relationship on a recording strip with this device so that, e.g., a midwife can watch the parturition by means of these recordings.
However, the CTG process does not supply any direct parameters. The recordings must rather be interpreted by the midwife who consults a doctor when she is in doubt.
It is the object of the invention to provide a process and a device which supply absolute values of vital fetal parameters during parturition so that midwives get measuring values with clear statements.
In order to attain this object the invention provides that the blood pressure of the fetus is discontinuously measured in the arterial system by carrying out the occlusion process by means of the annular uterine tissue and the presenting part of the fetus and a pressure sensor and a sensor sensing the blood flow characteristics.
Thus, the invention uses the principle of occlusion measurement of the blood pressure.
Although this principle has been generally known for a long time, experts have not recognized that, due to a further development, this principle can surprisingly also be used for an indirect measurement of the blood pressure of the fetus during parturition.
In the known occlusion process for the indirect and discontinuous measuring of the blood pressure of a person, a cuff is placed around the upper arm. The cuff is inflated sufficiently with an air pump at the beginning of the measuring of blood pressure that all blood vessels collapse under the pressure of the cuff and there is no longer any blood flow. Then the air is slowly discharged from the cuff, the blood pressure range being slowly swept. As soon as the cuff pressure has slightly dropped below the systolic blood pressure, blood can again flow in the veins during the time of the highest arterial blood pressure of the systoles.
Since the veins are still largely compressed, a hissing noise is produced in the veins beyond the cuff during the short moment during which arterial blood flows into the arm, which can be auscultated by means of a stethoscope (Korotkow sounds).
The noise can also be detected, of course, by a microphone and can be evaluated, e.g., electronically.
During the further course of the measuring, the cuff pressure is continuously lowered. Korotkow sounds get louder and louder, but then softer gain. If the cuff pressure drops finally below the diastolic blood pressure, Korotkow sounds disappear completely.
The cuff pressure at which this noise occurs for the first time corresponds to the systolic blood pressure. The cuff pressure at which this noise disappears finally or clearly decreases in terms of intensity corresponds to the diastolic blood pressure.
SUMMARY OF THE INVENTION
In the process according to the invention the annular uterine tissue is directly or indirectly used for occlusion measuring in a surprising manner.
The process according to the invention is designed so that the annular uterine tissue is used as an occlusion cuff with respect to the presenting part of the infant during the maximum of a contraction (peak of contraction), the occlusion pressure (pressure in the cuff higher than the systolic arterial blood pressure of the fetus) between the uterine tissue and the presenting part of the infant being ascertained by a pressure sensor and a sensor sensing the blood flow characteristics, the systolic and the diastolic arterial blood pressure of the infant being determined as the contraction subsides.
If the contraction is strong enough, the blood flow is completely cut off in the relevant part of the fetus during the peak of a contraction. As the contraction subsides, the systolic and the diastolic blood pressure of the fetus can the
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Knitza Reinhold
Rall Gerhard
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