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入院时胎心监护:新生儿结局的预测指标。

Admission Cardiotocography: A Predictor of Neonatal Outcome.

作者信息

Bhartiya Vishnu, Sharma Richa, Kumar Anand, Srivastava Himsweta

机构信息

Department of Obstetrics and Gynecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, Delhi 110095 India.

Mrs. Girdhar Lal Maternity Hospital, Jawaharlal Nehru Marg, New Delhi, Delhi 110002 India.

出版信息

J Obstet Gynaecol India. 2016 Oct;66(Suppl 1):321-9. doi: 10.1007/s13224-016-0912-0. Epub 2016 Jun 14.

Abstract

BACKGROUND

Screening for fetal distress is a big challenge for obstetricians. Labor admission test by cardiotocography (CTG) can be utilized to differentiate between mothers, in whom continuous fetal monitoring is needed and those who can be managed by intermittent auscultation. Admission CTG is commonly used screening test which aims to identify on admission to the delivery unit the fetus at increased risk of intrapartum hypoxia. We conducted a study to evaluate the efficacy of CTG in low- and high-risk women.

METHODS

A prospective longitudinal study was conducted on 200 low-risk and high-risk antenatal women, beyond 32-week gestation with live pregnancy in labor and admitted in labor ward.

RESULTS

Correlation of labor admission test with meconium in low risk and high risk was found statistically significant (p = 0.0010 and p = 0.000046, respectively). Correlation of labor admission test with low Apgar score, NICU admission and mortality was found statistically insignificant in low-risk and high-risk groups.

CONCLUSION

Admission CTG does not benefit the neonatal outcome in normal- or low-risk women and rather results in increased obstetric intervention. Thus, it is not beneficial as a screening test to detect intrapartum fetal distress in normal- or low-risk women.

摘要

背景

对产科医生而言,筛查胎儿窘迫是一项巨大挑战。产时通过胎心监护(CTG)进行入院检查,可用于区分需要持续胎儿监测的产妇和可通过间歇性听诊管理的产妇。入院CTG是常用的筛查测试,旨在在产妇入院时识别有产时缺氧风险增加的胎儿。我们开展了一项研究,以评估CTG在低风险和高风险女性中的有效性。

方法

对200名妊娠32周以上、单胎活产且入住产房产科病房的低风险和高风险产前女性进行了一项前瞻性纵向研究。

结果

发现低风险和高风险组中,入院检查与胎粪的相关性具有统计学意义(分别为p = 0.0010和p = 0.000046)。在低风险和高风险组中,入院检查与低Apgar评分、入住新生儿重症监护病房及死亡率的相关性无统计学意义。

结论

入院CTG对正常或低风险女性的新生儿结局无益处,反而会导致产科干预增加。因此,作为检测正常或低风险女性产时胎儿窘迫的筛查测试并无益处。

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