评估胎儿心率图的 5 级系统优于 3 级系统，可识别胎儿酸中毒。
The 5-tier system of assessing fetal heart rate tracings is superior to the 3-tier system in identifying fetal acidemia.
机构信息
Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY, USA.
出版信息
Am J Obstet Gynecol. 2012 Mar;206(3):226.e1-5. doi: 10.1016/j.ajog.2011.12.014. Epub 2011 Dec 22.
OBJECTIVE
Electronic fetal heart rate monitoring was developed to identify fetuses at risk of acidemia for intervention before adverse outcomes. Our objective was to compare the 3-tier system with a 5-tier system in evaluation of fetal acidemia.
STUDY DESIGN
Retrospective case-control study of patients with a fetal arterial pH <7 matched to the next birth that resulted in a pH >7.2. Tracings were categorized into 3- and 5-tier systems by a single reviewer. Sensitivities and specificities were calculated for each.
RESULTS
Twenty-four cases and 24 controls were identified. The sensitivity for an orange or red tracing was higher than for category III, with more of these in the pH <7 group compared with controls (P ≤ .001). There were significantly more green, blue, and yellow tracings in the normal pH group compared with the pH <7 group (P = .033, P = .008, P = .023), respectively.
CONCLUSION
The 5-tier system had a better sensitivity than the 3-tier system.
目的
电子胎心监护旨在识别酸中毒风险胎儿，并在不良后果发生前进行干预。我们的目的是比较 3 级系统和 5 级系统在评估胎儿酸中毒中的应用。
研究设计
回顾性病例对照研究，选取胎儿动脉 pH 值<7 的患者与下一次 pH 值>7.2 的分娩相匹配。由一名评审员将胎心率描记图分为 3 级系统和 5 级系统。计算每个系统的敏感性和特异性。
结果
共确定了 24 例病例和 24 例对照。橙色或红色胎心率描记图的敏感性高于 3 级系统，且在 pH 值<7 的组中比对照组更多（P ≤.001）。在 pH 值正常组中，绿色、蓝色和黄色胎心率描记图明显更多，而在 pH 值<7 的组中则更少（P =.033，P =.008，P =.023）。
结论
5 级系统比 3 级系统具有更好的敏感性。
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