Abstract：
Relative uteroplacental insufficiency of labor (RUPI-L) is a clinical condition that refers to alterations in the fetal oxygen \"demand-supply\" equation caused by the onset of regular uterine activity. The term RUPI-L indicates a condition of \"relative\" uteroplacental insufficiency which is relative to a specific stressful circumstance, such as the onset of regular uterine activity. RUPI-L may be more prevalent in fetuses in which the ratio between the fetal oxygen supply and demand is already slightly reduced, such as in cases of subclinical placental insufficiency, post-term pregnancies, gestational diabetes, and other similar conditions. Prior to the onset of regular uterine activity, fetuses with a RUPI-L may present with normal features on the cardiotocography. However, with the onset of uterine contractions, these fetuses start to manifest abnormal fetal heart rate patterns which reflect the attempt to maintain adequate perfusion to essential central organs during episodes of transient reduction in oxygenation. If labor is allowed to continue without an appropriate intervention, progressively more frequent, and stronger uterine contractions may result in a rapid deterioration of the fetal oxygenation leading to hypoxia and acidosis. In this Commentary, we introduce the term relative uteroplacental insufficiency of labor and highlight the pathophysiology, as well as the common features observed in the fetal heart rate tracing and clinical implications.
摘要：
相对子宫胎盘分娩功能不全（RUPI-L）是一种临床状况，是指由正常子宫活动开始引起的胎儿氧气“需求-供应”方程的改变。术语RUPI-L表示与特定压力环境相关的“相对”子宫胎盘功能不全的状况，如正常的子宫活动开始。RUPI-L可能在胎儿中更普遍，在胎儿中，胎儿氧供需之间的比率已经略有降低，例如在亚临床胎盘功能不全的情况下，产后怀孕,妊娠期糖尿病,和其他类似的条件。在正常的子宫活动开始之前，具有RUPI-L的胎儿在心电图上可能表现出正常特征。然而,随着子宫收缩的开始，这些胎儿开始表现出异常的胎儿心率模式，这反映了在短暂的氧合减少期间试图维持对重要中枢器官的足够灌注。如果允许在没有适当干预的情况下继续分娩，越来越频繁，和更强的子宫收缩可能导致胎儿氧合迅速恶化，导致缺氧和酸中毒。在这篇评论中,我们介绍了相对子宫胎盘功能不全的术语，并强调了病理生理学，以及在胎儿心率追踪中观察到的共同特征和临床意义。
