East C E, Gascoigne M B, Doran C M, Brennecke S P, King J F, Colditz P B
Perinatal Research Centre, The University of Queensland, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
BJOG. 2006 Sep;113(9):1080-7. doi: 10.1111/j.1471-0528.2006.01044.x.
To report an economic analysis of the Australian intrapartum fetal pulse oximetry (FPO) multicentre randomised controlled trial (the FOREMOST trial), which examined whether adding FPO to conventional cardiotocographic (CTG) monitoring (intervention group) was cost-effective in reducing operative delivery rates for non-reassuring fetal status compared with the use of CTG alone (control group).
Cost-effectiveness analysis of the FOREMOST trial.
Four Australian maternity hospitals, each with more than 4000 births/year.
Women in labour at > or =36 weeks of gestation, with a non-reassuring CTG.
Costs were for treatment-related expenses, incorporating diagnosis-related grouping costs and direct costs (including fetal monitoring). Incremental cost-effectiveness ratio (ICER) and cost-effectiveness plane were calculated, and sensitivity analysis was conducted. The primary outcome was that of the clinical trial: operative delivery for non-reassuring fetal status avoided in the intervention group relative to that in the control group.
The ICER.
The ICER demonstrated a saving of $A813 for each operative birth for non-reassuring fetal status averted by the addition of FPO to CTG monitoring compared with the use of CTG monitoring alone.
The addition of FPO to CTG monitoring represented a less costly and more effective use of resources to reduce operative delivery rates for non-reassuring fetal status than the use of conventional CTG monitoring alone.
报告澳大利亚产时胎儿脉搏血氧饱和度测定（FPO）多中心随机对照试验（FOREMOST试验）的经济分析，该试验旨在研究与单独使用传统胎心监护（CTG）监测（对照组）相比，在传统CTG监测基础上增加FPO监测（干预组）对于降低因胎儿状况不佳导致的手术分娩率是否具有成本效益。
FOREMOST试验的成本效益分析。
四家澳大利亚妇产医院，每家医院每年分娩量超过4000例。
妊娠≥36周、CTG监护结果异常的临产妇女。
成本为与治疗相关的费用，包括诊断相关分组成本和直接成本（包括胎儿监测）。计算增量成本效益比（ICER）和成本效益平面，并进行敏感性分析。主要结局为临床试验的结局：干预组相对于对照组避免因胎儿状况不佳而进行手术分娩的情况。
ICER。
与单独使用CTG监测相比，在CTG监测基础上增加FPO监测，每避免一例因胎儿状况不佳而进行的手术分娩可节省813澳元。
与单独使用传统CTG监测相比，在CTG监测基础上增加FPO监测是一种成本更低且更有效地利用资源降低因胎儿状况不佳导致的手术分娩率的方法。
