Department of Obstetrics and Gynecology, Columbia University, New York, NY, USA.
Am J Obstet Gynecol. 2011 Sep;205(3):288.e1-4. doi: 10.1016/j.ajog.2011.06.065. Epub 2011 Jun 24.
In 2008, a National Institute of Child Health and Human Development/Society for Maternal-Fetal Medicine-sponsored workshop on electronic fetal monitoring recommended a new fetal heart tracing interpretation system. Comparison of this 3-tier system with other systems is lacking. Our purpose was to determine the relationships between fetal heart rate categories for the 3 existing systems.
Three Maternal-Fetal Medicine specialists reviewed 120 fetal heart rates. All tracings were from term, singleton pregnancies with known umbilical artery pH. The fetal heart rates were classified by a 2-tier, 3-tier, and 5-tier system.
Each Maternal-Fetal Medicine examiner reviewed 120 fetal heart rate segments. When compared with the 2-tier system, 0%, 54%, and 100% tracings in categories 1, 2, and 3 were "nonreassuring." There was strong concordance between category 1 and "green" as well as category 3 and "red" tracings.
The 3-tier and 5-tier systems were similar in fetal heart rate interpretations for tracings that were either very normal or very abnormal. Whether one system is superior to the others in predicting fetal acidemia remains unknown.
2008 年，由美国国立儿童健康与人类发展研究院/母婴医学学会主办的电子胎心监护研讨会推荐了一种新的胎心监护图解读系统。该系统与其他系统的比较尚缺乏相关研究。本研究旨在明确三种现有的胎心监护分类系统之间的关系。
三位母胎医学专家对 120 份胎心监护图进行了分析。所有监护图均来自足月、单胎、已知脐动脉 pH 值的妊娠。胎心监护图按照 2 分制、3 分制和 5 分制进行分类。
每位母胎医学专家均分析了 120 份胎心监护片段。与 2 分制相比，1 分、2 分和 3 分中“非反应型”的监护片段分别为 0%、54%和 100%。1 分和“绿色”以及 3 分和“红色”监护片段之间具有高度一致性。
3 分制和 5 分制对于胎心监护图中非常正常或非常异常的片段的解读相似。在预测胎儿酸中毒方面，哪种系统更优尚不清楚。
