Lamvu Georgine M, Thorp John M, Stuart Nancy, Hartmann Katherine E
Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, 101 Manning Drive, CB 7570 MacNider Building, Chapel Hill, NC 27599-7508, USA.
J Reprod Med. 2006 Sep;51(9):689-93.
To conduct a retrospective, cohort study to determine the impact of abnormal outpatient fetal heart rate (FHR) testing on maternal interventions in labor, including labor induction, operative vaginal delivery and unplanned cesarean section.
Our cohort consisted of 1,386 women with singleton gestations who had outpatient fetal nonstress testing within 1 week prior to giving birth etween 1993 and 1998. Antepartum FHR records were interpreted as reassuring or nonreassuring, and pregnancy records were abstracted for background medical information, labor interventions and pregnancy outcomes. Logistic regression models were used to describe the association between abnormal outpatient monitoring results and maternal interventions in labor.
After adjusting for potential confounders (maternal age, race, prior history of cesarean section, antepartum indications for monitoring, fetal presentation and abnormal fetal heart rate patterns in labor), women with nonreassuring monitoring were 90% more likely to undergo induction. The 2 groups were similar in operative vaginal delivery rates, but pregnancies with nonreassuring testing were more than twice as likely to end with an unplanned cesarean section.
Abnormal outpatient antenatal FHR testing may be independently associated with an increased risk of unplanned cesarean section.
进行一项回顾性队列研究，以确定门诊胎儿心率（FHR）检测异常对产妇分娩干预措施的影响，这些干预措施包括引产、阴道助产和计划外剖宫产。
我们的队列包括1993年至1998年间分娩前1周内进行门诊胎儿无应激试验的1386名单胎妊娠妇女。产前FHR记录被解读为令人放心或不令人放心，并提取妊娠记录以获取背景医疗信息、分娩干预措施和妊娠结局。采用逻辑回归模型来描述门诊监测结果异常与产妇分娩干预措施之间的关联。
在对潜在混杂因素（产妇年龄、种族、既往剖宫产史、产前监测指征、胎儿先露情况和分娩时异常胎儿心率模式）进行校正后，监测结果不令人放心的妇女引产的可能性增加90%。两组阴道助产率相似，但监测结果不令人放心的妊娠以计划外剖宫产结束的可能性是前者的两倍多。
门诊产前FHR检测异常可能与计划外剖宫产风险增加独立相关。
