Giuliano N, Annunziata M L, Tagliaferri S, Esposito F G, Imperato O C M, Campanile M, Signorini M G, Di Lieto A
Department of Public Health, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy.
Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, Italy.
J Pregnancy. 2014;2014:620976. doi: 10.1155/2014/620976. Epub 2014 Dec 9.
Analyzing velocimetric (umbilical artery, UA; ductus venosus, DV; middle cerebral artery, MCA) and computerized cardiotocographic (cCTG) (fetal heart rate, FHR; short term variability, STV; approximate entropy, ApEn) parameters in intrauterine growth restriction, IUGR, in order to detect early signs of fetal compromise. POPULATION STUDY: 375 pregnant women assisted from the 28th week of amenorrhea to delivery and monitored through cCTG and Doppler ultrasound investigation. The patients were divided into three groups according to the age of gestation at the time of delivery, before the 34th week, from 34th to 37th week, and after the 37th week. Data were analyzed in relation to the days before delivery and according to the physiology or pathology of velocimetry. Statistical analysis was performed through the t-test, chi-square test, and Pearson correlation test (P < 0.05). Our results evidenced an earlier alteration of UA, DV, and MCA. The analysis between cCTG and velocimetric parameters (the last distinguished into physiological and pathological values) suggests a possible relation between cCTG alterations and Doppler ones. The present study emphasizes the need for an antenatal testing in IUGR fetuses using multiple surveillance modalities to enhance prediction of neonatal outcome.
分析宫内生长受限（IUGR）胎儿的测速参数（脐动脉、UA；静脉导管、DV；大脑中动脉、MCA）和计算机化心动图（cCTG）参数（胎儿心率、FHR；短期变异性、STV；近似熵、ApEn），以检测胎儿窘迫的早期迹象。人群研究：375名孕妇从闭经第28周开始接受检查直至分娩，并通过cCTG和多普勒超声检查进行监测。根据分娩时的孕周将患者分为三组，即34周前、34至37周以及37周后。根据分娩前的天数以及测速的生理或病理情况对数据进行分析。通过t检验、卡方检验和Pearson相关检验进行统计分析（P < 0.05）。我们的结果表明UA、DV和MCA出现了更早的改变。cCTG与测速参数（最后分为生理值和病理值）之间的分析表明cCTG改变与多普勒参数之间可能存在关联。本研究强调，对于IUGR胎儿需要采用多种监测方式进行产前检查，以提高对新生儿结局的预测。
