Tan Kelvin H, Smyth Rebecca M D, Wei Xing
Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, Singapore, 229899.
Cochrane Database Syst Rev. 2013 Dec 7;2013(12):CD002963. doi: 10.1002/14651858.CD002963.pub2.
Acoustic stimulation of the fetus has been suggested to improve the efficiency of antepartum fetal heart rate testing.
To assess the advantages and disadvantages of the use of fetal vibroacoustic stimulation in conjunction with tests of fetal wellbeing.
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2013).
All published and unpublished randomised controlled trials assessing the merits of the use of fetal vibroacoustic stimulation in conjunction with tests of fetal wellbeing.
All review authors independently extracted data and assessed trial quality. Authors of published and unpublished trials were contacted for further information.
Altogether 12 trials with a total of 6822 participants were included. Fetal vibroacoustic stimulation reduced the incidence of non-reactive antenatal cardiotocography test (nine trials; average risk ratio (RR) 0.62, 95% confidence interval (CI) 0.48 to 0.81). Vibroacoustic stimulation compared with mock stimulation evoked significantly more fetal movements when used in conjunction with fetal heart rate testing (one trial, RR 0.23, 95% CI 0.18 to 0.29).
AUTHORS' CONCLUSIONS: Vibroacoustic stimulation offers benefits by decreasing the incidence of non-reactive cardiotocography and reducing the testing time. Further randomised trials should be encouraged to determine not only the optimum intensity, frequency, duration and position of the vibroacoustic stimulation, but also to evaluate the efficacy, predictive reliability, safety and perinatal outcome of these stimuli with cardiotocography and other tests of fetal wellbeing.
已有研究表明,对胎儿进行声音刺激可提高产前胎儿心率检测的效率。
评估使用胎儿声振刺激结合胎儿健康状况检测的优缺点。
我们检索了Cochrane妊娠与分娩组试验注册库(2013年9月30日)。
所有已发表和未发表的随机对照试验,评估使用胎儿声振刺激结合胎儿健康状况检测的优点。
所有综述作者独立提取数据并评估试验质量。已发表和未发表试验的作者被联系以获取更多信息。
共纳入12项试验,总计6822名参与者。胎儿声振刺激降低了无反应型产前胎心监护试验的发生率(9项试验;平均风险比(RR)0.62,95%置信区间(CI)0.48至0.81)。与模拟刺激相比,声振刺激在与胎儿心率检测联合使用时能显著诱发更多胎儿运动(1项试验,RR 0.23,95%CI 0.18至0.29)。
声振刺激通过降低无反应型胎心监护的发生率和缩短检测时间带来益处。应鼓励进一步开展随机试验,不仅要确定声振刺激的最佳强度、频率、持续时间和位置,还要评估这些刺激与胎心监护及其他胎儿健康状况检测方法相比的疗效、预测可靠性、安全性和围产期结局。