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脑胎盘比率在低风险足月妊娠产时胎儿监测预测中的价值

The Value of the Cerebroplacental Ratio for the Prediction of Intrapartum Fetal Monitoring in Low-Risk Term Pregnancies.

作者信息

Liu Jing, Song Guang, Zhao Ge, Meng Tao

机构信息

Department of Obstetrics, The First Affiliated Hospital of China Medical University, Shenyang, China.

出版信息

Gynecol Obstet Invest. 2017;82(5):475-480. doi: 10.1159/000452664. Epub 2016 Oct 29.

Abstract

AIM

The study aimed to investigate the use of fetal cerebroplacental ratio (CPR) to identify fetuses at high risk before labor due to the brain sparing phenomenon.

MATERIALS AND METHODS

Four hundred and seventy-six singleton pregnancies were enrolled in this study. The CPR was recorded within 1 week of delivery and labor was managed according to local protocols and guidelines. Intrapartum and neonatal outcome details were recorded.

RESULTS

The CPR values of fetuses subsequently presenting category III intrapartum electronic fetal monitoring (EFM) or category II EFM without improvement (category IIB EFM) or with progression to category III (category IIC EFM) were significantly lower. On multivariate logistic regression, CPR was independently associated with the risk of categories III EFM, IIB EFM and IIC EFM. CPR was also a predictor of categories III EFM, IIB EFM and IIC EFM.

CONCLUSIONS

Fetal CPR could be used to identify fetuses at high risk before labor and to help guide intrapartum management decisions.

摘要

目的

本研究旨在探讨利用胎儿脑胎盘比率(CPR)来识别因脑保护现象而在分娩前处于高危状态的胎儿。

材料与方法

本研究纳入了476例单胎妊娠。在分娩前1周内记录CPR,并根据当地方案和指南进行分娩管理。记录产时及新生儿结局细节。

结果

随后出现Ⅲ类产时电子胎儿监护(EFM)或Ⅱ类EFM且无改善(ⅡB类EFM)或进展为Ⅲ类(ⅠIC类EFM)的胎儿的CPR值显著更低。在多因素逻辑回归分析中,CPR与Ⅲ类EFM、ⅡB类EFM和ⅠIC类EFM的风险独立相关。CPR也是Ⅲ类EFM、ⅡB类EFM和ⅠIC类EFM的预测指标。

结论

胎儿CPR可用于识别分娩前的高危胎儿,并有助于指导产时管理决策。

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