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[高危人群中胎儿脐血穿刺及胎儿健康评估(一项非常可靠的指标)]

[Cordocentesis and evaluation of fetal wellbeing in a very high-risk population (a very reliable index)].

作者信息

Montenegro C A, Meirelles Filho J, Fonseca A L, Netto H C, Amim Júnior J, Rezende Filho J, Jacyntho C

机构信息

Maternidade-Escola de l'Université Fédérale de Rio de Janeiro, Brésil.

出版信息

Rev Fr Gynecol Obstet. 1992 Oct;87(10):467-8, 471-7.

PMID:1470819
Abstract

In a population of 57 very high-risk pregnant women (severe clinical history and/or compromised fetus). A total of 240 tests for antepartum fetal evaluation were performed: baseline cardiotocography (CTG), biophysical profile scoring (BPS), doppler-velocimetry of umbilical artery and determination of blood gas analysis in venous umbilical cord blood obtained by cordocentesis. The results of the CTG, BPS, and umbilical artery doppler velocimetry showed a significant relation with those of pH and pO2. The sensitivity, specificity, false-abnormal value, and false-normal value of the CTG, PBS, and doppler velocimetry, used for the diagnosis of fetal acidosis, hypoxia, and asphyxia were comparable. The rate of fetal (asphyxia) was high if present severe/terminal CTG (85.0%), abnormal (4) BPS (82.0%), or absent-end diastole in umbilical artery doppler velocimetry (74.0%). The immediate complication rate due to cordocentesis procedure was minimal.

摘要

在57名高危孕妇(有严重临床病史和/或胎儿情况不佳)群体中。总共进行了240次产前胎儿评估检查:基线胎心监护(CTG)、生物物理评分(BPS)、脐动脉多普勒血流测定以及通过脐静脉穿刺获取的脐静脉血血气分析测定。CTG、BPS和脐动脉多普勒血流测定结果与pH值和pO2结果显示出显著相关性。用于诊断胎儿酸中毒、缺氧和窒息的CTG、PBS和多普勒血流测定的敏感性、特异性、假异常值和假正常值具有可比性。如果出现严重/晚期CTG(85.0%)、异常(4项)BPS(82.0%)或脐动脉多普勒血流测定中舒张期末期血流缺失(74.0%),胎儿(窒息)发生率较高。脐静脉穿刺操作导致的即刻并发症发生率极低。

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