Tanaka Hiroaki, Furuhashi Fumi H, Toriyabe Kuniaki, Matsumoto Takeshi, Magawa Shoich, Nii Masafumi, Watanabe Junko, Tanaka Kayo, Umekawa Takashi, Kamimoto Yuki, Ikeda Tomoaki
a Department of Obstetrics and Gynecology , Mie University School of Medicine , Mie , Japan.
J Matern Fetal Neonatal Med. 2019 Oct;32(19):3221-3225. doi: 10.1080/14767058.2018.1461313. Epub 2018 Apr 18.
Fetal growth restriction (FGR) is a concerning health issue. However, studies on FGR management are limited due to its rarity. We aimed to evaluate the efficacy of the contraction stress test (CST) for FGR management. A case-control retrospective study design. Our institute innovated CST in FGR management in 2017. We included women in their 33rd-40th week of pregnancy with a diagnosis of FGR and retrospectively divided them into groups: the CST group (FGR management with CST) and no CST group (FGR management without CST) before and after CST development. Neonatal outcome, pH, and pO of umbilical artery (UA) were compared between the two groups. No significant differences in the rate of birth weight, Apgar score <7 (5 minutes), neonatal death, hospitalization to newborn childhood intensive care unit (NICU), and UA pH were found between groups. Average UA pH was 7.29 ± 0.05 and 7.29 ± 0.04 in the CST and no CST groups, respectively ( = .864). Average UA pO values were 21.1 ± 8.6 and 15.7 ± 5.0 mmHg in the CST and no CST groups, respectively ( = .016), showing significant differences. Neonatal outcomes and UA pH were slightly different between the groups managed with and without CST. However, UA pO values significantly differed between the groups. For FGR management, the use of a CST may allow for early intervention before fetal acidemia and acidosis. For establishing the effects of a CST for FGR management, analysis including several cases and investigation of long-term outcomes of newborn infants is necessary.
胎儿生长受限（FGR）是一个令人担忧的健康问题。然而，由于其罕见性，关于FGR管理的研究有限。我们旨在评估宫缩应激试验（CST）在FGR管理中的有效性。采用病例对照回顾性研究设计。我们的研究所于2017年在FGR管理中创新了CST。我们纳入了妊娠33至40周被诊断为FGR的女性，并在CST开展前后将她们回顾性地分为两组：CST组（采用CST进行FGR管理）和非CST组（不采用CST进行FGR管理）。比较两组的新生儿结局、脐动脉（UA）的pH值和pO值。两组之间在出生体重、1分钟阿氏评分<7分、新生儿死亡、入住新生儿重症监护病房（NICU）以及UA pH值方面未发现显著差异。CST组和非CST组的平均UA pH值分别为7.29±0.05和7.29±0.04（P = 0.864）。CST组和非CST组的平均UA pO值分别为21.1±8.6和15.7±5.0 mmHg（P = 0.016），显示出显著差异。采用和未采用CST管理的两组之间新生儿结局和UA pH值略有不同。然而，两组之间的UA pO值存在显著差异。对于FGR管理，使用CST可能允许在胎儿酸血症和酸中毒之前进行早期干预。为了确定CST在FGR管理中的效果，有必要进行包括多个病例的分析以及对新生儿长期结局的研究。
