Sultana Jobaida, Chowdhury T A, Begum Kohinoor, Khan Manir Hossain
Department of Obstetrics & Gynaecology, Dhaka Medical College Hospital, Dhaka, Bangladesh.
Mymensingh Med J. 2009 Jan;18(1 Suppl):S103-107.
Cardiotocography (CTG) is the most commonly used test for antepartum and intrapartum foetal surveillance in the majority hospitals of developed countries. The purpose of this study was to compare the pregnancy outcome and early neonatal outcome among the normal and abnormal CTG groups. In this prospective study, fifty consecutive normal and fifty consecutive abnormal CTG were collected within one hour before delivery from patients who have singleton pregnancy with gestational age >or=32 weeks and having obstetric or medical indication for CTG. In this study, the measure of pregnancy outcomes were mode of delivery, indications of caesarean section, percentage requiring caesarean section for foetal distress, oligohydramnios, meconium stained liquor, small placenta and cord around the neck. Early neonatal outcomes included apgar score, birth weight, admission into neonatal intensive care unit (NICU), duration of stay in NICU and perinatal mortality. There were significant differences between the two groups regarding pregnancy outcomes and early neonatal outcomes. So, CTG is an important test to assess the foetal condition in both antepartum and intrapartum period. The sensitivity of CTG was 87%, specificity was 66%, positive predictive value was 54% and negative predictive value was 92% in the prediction of abnormal outcomes. So, normal CTG is more predictive of normal outcomes than abnormal CTG regarding abnormal outcomes.
胎心监护(CTG)是发达国家大多数医院产前和产时胎儿监测最常用的检查方法。本研究的目的是比较正常和异常CTG组的妊娠结局和早期新生儿结局。在这项前瞻性研究中,从孕周≥32周的单胎妊娠且有CTG产科或医学指征的患者中,在分娩前1小时内连续收集50例正常CTG和50例异常CTG。在本研究中,妊娠结局的衡量指标包括分娩方式、剖宫产指征、因胎儿窘迫行剖宫产的百分比、羊水过少、羊水粪染、胎盘小和脐带绕颈。早期新生儿结局包括阿氏评分、出生体重、入住新生儿重症监护病房(NICU)、在NICU的住院时间和围产期死亡率。两组在妊娠结局和早期新生儿结局方面存在显著差异。因此,CTG是评估产前和产时胎儿状况的一项重要检查。CTG预测异常结局的敏感性为87%,特异性为66%,阳性预测值为54%,阴性预测值为92%。所以,对于异常结局,正常CTG比异常CTG更能预测正常结局。