高危产科患者入院时的胎心监护筛查
Admission Cardiotocography Screening of High Risk Obstetric Patients.
作者信息
Sandhu G S, Raju R, Bhattacharyya T K
机构信息
Senior Advisor (Obstetrics & Gynaecology), CH AF Bangalore.
Fellow (Reproductive Medicine), CMC, Vellore.
出版信息
Med J Armed Forces India. 2008 Jan;64(1):43-5. doi: 10.1016/S0377-1237(08)80145-1. Epub 2011 Jul 21.
BACKGROUND
To predict the neonatal outcome in high risk obstetric cases by admission cardiotocography (CTG) testing.
METHODS
A total of 150 consecutive high risk obstetric patients meeting the inclusion criteria were subjected to admission CTG testing in this prospective study. The CTG tracing was categorized based on Royal College of Obstetricians and Gynaecologists (RCOG) criteria. Specific foetal and neonatal outcome measures were studied and correlated with the admission CTG testing.
RESULT
Foetal distress during labour developed in 15% of patients with a normal test and in 73% of patients with an abnormal test. The admission test had a sensitivity of 66.7%, specificity of 93.3% and a positive predictive value of 53.3% for predicting an Apgar score < 5 at birth. Neonatal admission to neonatal intensive care unit was required in 1% of patients with a normal test and 33% of patients with an abnormal test (p <0.01).
CONCLUSION
The result of admission cardiotocography testing could be used to identify patients likely to develop adverse foetal outcomes and help in optimal utilization of labour room resources.
背景
通过入院时的胎心监护（CTG）检测预测高危产科病例的新生儿结局。
方法
在这项前瞻性研究中，共有150例符合纳入标准的连续高危产科患者接受了入院时的CTG检测。根据皇家妇产科学院（RCOG）标准对CTG描记进行分类。研究了特定的胎儿和新生儿结局指标，并将其与入院时的CTG检测结果相关联。
结果
检测结果正常的患者中15%在分娩期间出现胎儿窘迫，检测结果异常的患者中73%出现胎儿窘迫。入院检测对于预测出生时阿氏评分＜5的敏感性为66.7%，特异性为93.3%，阳性预测值为53.3%。检测结果正常的患者中有1%、检测结果异常的患者中有33%的新生儿需要入住新生儿重症监护病房（p＜0.01）。
结论
入院胎心监护检测结果可用于识别可能出现不良胎儿结局的患者，并有助于优化产房资源的利用。
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