用于产时早期胎儿监测的胎儿声刺激试验

Fetal acoustic stimulation test for early intrapartum fetal monitoring.

作者信息

Goonewardene M, Hanwellage K

机构信息

Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka.

出版信息

Ceylon Med J. 2011 Mar;56(1):14-8. doi: 10.4038/cmj.v56i1.2889.

DOI:10.4038/cmj.v56i1.2889

PMID:21542428

Abstract

INTRODUCTION

The fetal acoustic stimulation test (FAST) is a simple cost effective screening test for antenatal fetal monitoring. The aim of the study was to evaluate the FAST as a screening test for early intrapartum fetal well being.

METHODS

An initial non stress test (NST) followed by a FAST using corometric model 146 was carried out in 486 participants in early labour with uncomplicated singleton pregnancies and > 32 weeks gestation. A repeat NST was recorded in the participants who had an initial non reactive NST. The results of the NST and FAST were compared with fetal outcome. Maternal perception of fetal movements after FAST, results of NST before and after FAST, and the babies' 5 minute APGAR scores were measured.

RESULTS

Of the 486 participants 413 (85%) noticed fetal movements after FAST. Initial NST was non reactive in 203 (42%) but 149 (31%) became reactive after FAST. Compared to the NST, FAST had a better sensitivity (97% vs 62%, p < 0.001), specificity (100% vs 87%, p = 0.017), positive predictive value (100% vs 98%, p = 0.024), negative predictive value (79% vs 17%, p < 0.001) and accuracy (99%vs 64%, p < 0.001) in predicting 5 minute APGAR < 7 in the baby.

CONCLUSIONS

FAST is a reliable screening test for assessing fetal well being in early labour. It complements the NST and is better than the NST alone.

摘要

引言

胎儿声刺激试验（FAST）是一种用于产前胎儿监测的简单且经济有效的筛查试验。本研究的目的是评估FAST作为产程早期胎儿健康状况的筛查试验。

方法

对486例妊娠≥32周、单胎妊娠且产程早期无并发症的参与者进行了初始无应激试验（NST），随后使用146型宫缩压力计模型进行FAST。对初始NST无反应的参与者记录重复NST。将NST和FAST的结果与胎儿结局进行比较。测量了FAST后母亲对胎儿活动的感知、FAST前后NST的结果以及婴儿的5分钟阿氏评分。

结果

486例参与者中，413例（85%）在FAST后察觉到胎儿活动。初始NST无反应的有203例（42%），但149例（31%）在FAST后变为有反应。与NST相比，在预测婴儿5分钟阿氏评分<7方面，FAST具有更好的敏感性（97%对62%，p<0.001）、特异性（100%对87%，p = 0.017）、阳性预测值（100%对98%，p = 0.024）、阴性预测值（79%对17%，p<0.001）和准确性（99%对64%，p<0.001）。