Department of Obstetrics and Gynaecology, University of Birmingham, Birmingham Women's Hospital, Birmingham, UK.
Ultrasound Obstet Gynecol. 2011 Feb;37(2):135-42. doi: 10.1002/uog.7767. Epub 2011 Jan 12.
We investigated the accuracy of fetal umbilical artery Doppler to predict the risk of compromise of fetal/neonatal wellbeing in a high-risk population.
Searches in MEDLINE, Embase, The Cochrane Library and Medion (from inception to March 2009) were carried out, together with hand searching of relevant journals, reference list checking of included articles and contact with experts. Criteria for selection were observational studies with umbilical artery Doppler used in a high-risk pregnant population with an outcome measure for compromise of fetal/neonatal wellbeing. Data on study design, quality and results were extracted to construct 2 × 2 tables. Bivariate meta-analysis was performed. Likelihood ratios (LRs) were used as the summary measure of accuracy.
One-hundred and four studies met the selection criteria (19 191 fetuses). In a high-risk population, umbilical artery Doppler predicted small-for-gestational age with a pooled LR+ of 3.76 (2.96, 4.76) and pooled LR- of 0.52 (0.45, 0.61), and compromise of fetal/neonatal wellbeing with a pooled LR+ of 3.41 (2.68, 4.34) and pooled LR- of 0.55 (0.48, 0.62). In this group it was also possible to predict, with accuracy, intrauterine death (pooled LR+ = 4.37 (0.88, 21.8); pooled LR- = 0.25 (0.07, 0.91)) and acidosis (pooled LR+ = 2.75 (1.48, 5.11); pooled LR- = 0.58 (0.36, 0.94)).
In a high-risk population, fetal umbilical artery Doppler is a moderately useful test with which to predict mortality and risk of compromise.
我们研究了胎儿脐动脉多普勒在高危人群中预测胎儿/新生儿健康状况受损风险的准确性。
对 MEDLINE、Embase、The Cochrane Library 和 Medion 进行了检索（从建库至 2009 年 3 月），并进行了相关杂志的手工检索、纳入文章的参考文献核对以及与专家联系。入选标准为使用脐动脉多普勒对高危孕妇人群进行观察性研究，以评估胎儿/新生儿健康状况受损的结局。提取研究设计、质量和结果的数据以构建 2×2 表格。进行双变量 meta 分析。采用似然比（LR）作为准确性的综合指标。
共有 104 项研究符合入选标准（19 191 例胎儿）。在高危人群中，脐动脉多普勒预测胎儿小于胎龄的汇总 LR+为 3.76（2.96，4.76），LR-为 0.52（0.45，0.61），预测胎儿/新生儿健康状况受损的汇总 LR+为 3.41（2.68，4.34），LR-为 0.55（0.48，0.62）。在此人群中，还可以准确预测胎儿宫内死亡（汇总 LR+ = 4.37（0.88，21.8）；LR- = 0.25（0.07，0.91））和酸中毒（汇总 LR+ = 2.75（1.48，5.11）；LR- = 0.58（0.36，0.94））。
在高危人群中，胎儿脐动脉多普勒是一种中等有用的检测方法，可用于预测死亡率和受损风险。
