Cito Giuseppe, Luisi Stefano, Mezzesimi Alessandra, Cavicchioli Chiara, Calonaci Giulia, Petraglia Felice
Obstetrics and Gynecology, Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy.
Acta Obstet Gynecol Scand. 2005 Apr;84(4):335-8. doi: 10.1111/j.0001-6349.2005.00644.x.
The aim of the study was to determinate whether maternal position during the non-stress test (NST) in different weeks of pregnancy influences fetal heart rate patterns.
A total of 1055 NST lasting 30 min were performed in 368 autochthonous mothers with low-risk pregnancies. On the basis of maternal position during the test we divided into three groups: reclining, sitting, and walking. The cardiotocographic parameters considered were: number of minutes of reactive NST with minimum length, number of fetal movements, fetal heart rate baseline, number of large accelerations, number of dubious NST, and number of variable decelerations.
Fetal heart rate patterns in low-risk pregnancies were studied using NST in different gestational ages and in different maternal positions. Differences in heart rate were found in relationship to both gestational age and maternal position. The minimum length of NST necessary to record at least three large accelerations was significantly different in relationship to both gestational age and maternal position. The number of fetal movements perceived by the mother was greater in the reclining position than in sitting or walking. Together with the progression of pregnancy, the number of dubious NST decreased in all subgroups, especially in the sitting position. The greatest number of variable decelerations was observed in the reclining position and it was increased with pregnancy progression. The NST duration did not vary greatly in the reclining position, but in the sitting position or during walking, the time taken to record the three large accelerations required to define the trace as reactive, decreased significantly with the progression of pregnancy
Non-stress test in sitting position or during walking should be encouraged because fetal reactivity is more quickly observed.
本研究旨在确定妊娠不同孕周进行无应激试验（NST）时母亲的体位是否会影响胎儿心率模式。
对368例低风险妊娠的本地母亲进行了总共1055次持续30分钟的NST。根据试验期间母亲的体位，我们将其分为三组：仰卧位、坐位和行走位。所考虑的胎心监护参数包括：具有最短时长的反应性NST分钟数、胎动次数、胎儿心率基线、大幅度加速次数、可疑NST次数和变异减速次数。
在不同孕周和不同母亲体位下使用NST研究了低风险妊娠的胎儿心率模式。发现心率在孕周和母亲体位方面均存在差异。记录至少三次大幅度加速所需的NST最短时长在孕周和母亲体位方面均有显著差异。母亲感觉到的胎动次数在仰卧位时多于坐位或行走位。随着孕周的增加，所有亚组中可疑NST的次数均减少，尤其是在坐位时。在仰卧位观察到的变异减速次数最多，且随着孕周进展而增加。在仰卧位时NST持续时间变化不大，但在坐位或行走时，记录将轨迹定义为反应性所需的三次大幅度加速所需的时间随着孕周进展显著减少。
应鼓励在坐位或行走时进行无应激试验，因为能更快观察到胎儿反应性。
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