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[胎儿心电图(ECG)作为多普勒超声心动图(CTG)的替代方法用于产前胎儿健康评估——初步结果]

[Foetal electrocardiography (ECG) is an alternative to Doppler ultrasound cardiotocogram (CTG) for antenatal assessment of foetal well-being--preliminary results].

作者信息

Reinhard J, Hatzmann H, Schiermeier S

机构信息

Frauenklinik der Universität Witten-Herdecke, Marien-Hospital, Witten, Germany.

出版信息

Z Geburtshilfe Neonatol. 2008 Dec;212(6):226-9. doi: 10.1055/s-0028-1098718. Epub 2008 Dec 12.

DOI:10.1055/s-0028-1098718
PMID:19085740
Abstract

INTRODUCTION

Computer analysing software is required for the assessment of CTGs because of the low sensitivity and high intra- and interobserver variability. The German Society of Gynaecology and Obstetrics advises the use of computer analysing CTG software. This study is aimed at evaluating the use of a new foetal ECG analysis system as an alternative to the traditional Doppler ultrasound CTGs in the setting of a university labour suite.

MATERIALS AND METHODS

10 pregnant women beyond the 32 (nd) week of gestation, who were admitted to hospital and gave informed consent to this study, were connected to the foetal EKG monitor system Monica AN24. Patient satisfaction, maternal and foetal EKG detection rates and time required to connect the patient were evaluated.

RESULTS

8 out of 10 women would prefer the Monica AN24 monitor system over the traditional Doppler ultrasound CTG. In total, the mean foetal ECG detection rate was 62.3 % (SD +/- 30.4) during the recorded time interval; at rest the detection rate was 75.3 % (SD +/- 33.2); during the night time (23.00 to 7.00) the detection rate was 78.3 % (SD +/- 25.4); and during night time and at rest the detection rate was 82.2 % (SD +/- 24.3). The mean recorded time interval was 6 h and 54 min (SD +/- 2 h and 43 min). In total, the maternal ECG detection rate was as high as 99.7 % (SD +/- 0.4). The mean time required for applying the Monica AN24 monitor system was 3.2 min (SD +/- 0.6).

CONCLUSION

The foetal ECG monitor system may be a good alternative to Doppler ultrasound CTGs. With the perspective to analyse in a beat to beat manner foetal EKG heart rates, this new monitor system should be superior to Doppler ultrasound CTGs, however further larger studies are needed to confirm this hypothesis.

摘要

引言

由于灵敏度低以及观察者内和观察者间变异性高,评估产时胎心监护图(CTG)需要计算机分析软件。德国妇产科学会建议使用计算机分析CTG软件。本研究旨在评估一种新型胎儿心电图分析系统在大学产房环境中作为传统多普勒超声CTG的替代方法的使用情况。

材料与方法

10名妊娠超过32周、入院并对本研究给予知情同意的孕妇连接到胎儿心电图监测系统Monica AN24。评估了患者满意度、母体和胎儿心电图检测率以及连接患者所需时间。

结果

10名女性中有8名更喜欢Monica AN24监测系统而非传统的多普勒超声CTG。在记录的时间间隔内,胎儿心电图的平均检测率为62.3%(标准差±30.4);静息时检测率为75.3%(标准差±33.2);夜间(23:00至7:00)检测率为78.3%(标准差±25.4);夜间且静息时检测率为82.2%(标准差±2,4.3)。平均记录时间间隔为6小时54分钟(标准差±2小时43分钟)。母体心电图检测率高达99.7%(标准差±0.4)。应用Monica AN24监测系统的平均所需时间为3,2分钟(标准差±0.6)。

结论

胎儿心电图监测系统可能是多普勒超声CTG的良好替代方法。鉴于能够逐搏分析胎儿心电图心率,这种新型监测系统应优于多普勒超声CTG,然而需要进一步的大规模研究来证实这一假设。

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