Arulkumaran S, Anandakumar C, Wong Y C, Ratnam S S
Department of Obstetrics and Gynecology, National University of Singapore.
Obstet Gynecol. 1989 Feb;73(2):182-6.
Maternal perception of sound-provoked fetal movement was correlated with the results of nonstress cardiotocography in 1097 women with obstetric or medical antenatal risk factors. Ninety-two percent of the mothers felt fetal movements with the stimulus; all but three had a reactive non-stress test (NST). These three women were taking multiple antihypertensive drugs and were less than 33 weeks' gestation. Of 88 patients with no maternal perception of sound-provoked fetal movement, ten had nonreactive NSTs. Ultrasound confirmed the absence of fetal movement to the stimulus. The outcome in nine of these ten cases suggested some evidence of fetal compromise. Maternal perception of sound-provoked fetal movement correlated well with the results of the NST; the sensitivity (76.9%), specificity (92.8%), and negative predictive value (99.7%) were all high, although the positive predictive value was only 11.4%. Maternal perception of sound-provoked fetal movement may suffice as an inexpensive and simple method of evaluating antenatal fetal well-being in risk situations. When the mother is doubtful or does not feel the sound-provoked fetal movement, NST is indicated to evaluate the fetal health.
1097名有产科或内科产前危险因素的孕妇中,母亲对声音诱发的胎动的感知与无应激胎心监护结果相关。92%的母亲在刺激下感觉到胎动;除3名孕妇外,其余所有孕妇的无应激试验(NST)均呈反应型。这3名孕妇正在服用多种降压药物,且妊娠不足33周。在88名母亲未感觉到声音诱发胎动的患者中,10名患者的NST无反应。超声检查证实对刺激无胎动。这10例病例中有9例的结果提示有胎儿窘迫的一些证据。母亲对声音诱发胎动的感知与NST结果相关性良好;敏感性(76.9%)、特异性(92.8%)和阴性预测值(99.7%)均较高,尽管阳性预测值仅为11.4%。母亲对声音诱发胎动的感知可作为一种廉价且简单的方法,用于评估高危情况下的产前胎儿健康状况。当母亲有疑问或未感觉到声音诱发的胎动时,应进行NST以评估胎儿健康状况。