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不同体位对无应激试验时产妇血液动力学参数、满意度和胎儿胎心监护图形的影响。

The effect of different positions during non-stress test on maternal hemodynamic parameters, satisfaction, and fetal cardiotocographic patterns.

机构信息

Maternity and Childhood Nursing Department, Nursing College, Najran University, Najran, Kingdom of Saudi Arabia.

Obstetrics and Woman Health Nursing Department, Benha University, Benha, Egypt.

出版信息

Afr J Reprod Health. 2021 Feb;25(1):81-89. doi: 10.29063/ajrh2021/v25i1.10.

Abstract

Maternal position is one of the most important factors to be considered during Non-Stress Test (NST). It should be a part of practice guidelines, where the appropriate maternal position reduces test-related errors and false-positive results. This study aimed to investigate the effect of different maternal positions during NST on maternal hemodynamic parameters, satisfaction, and fetal Cardiotocographic (CTG) pattern. A quasi-experimental research design was conducted at NST clinic, outpatient department/ Maternal and Children hospital at Najran city, Saudi Arabia. The study comprised a convenience sample of 118 low-risk pregnant women in their third trimester of pregnancy. Data was collected from January to June 2020. All women were assessed in the three different positions; supine, left lateral, and semi-fowler position concerning CTG pattern, maternal hemodynamic parameters, and satisfaction. The study results indicated a higher Fetal Heart Rate (FHR), increased accelerations, and fetal movement in the left lateral position, followed by a semi-fowler position compared to the supine position with statistically significant differences. No statistically significant differences (P>0.05) were observed regarding FHR variability and NST reactivity in the three positions. In addition, there were statistically significant differences (P <0.05) between the different maternal positions regarding maternal heart rate, systolic Blood pressure (BP), diastolic BP, and maternal satisfaction. The current study concluded that left lateral and semi- fowler positions were associated with a more favorable CTG pattern, maternal hemodynamic parameters, and satisfaction than the supine position. Left lateral and semi-fowler positions during the NST test should be standardized to reduce practical variations among health care providers, which, in turn, may reduce the need for unnecessary, expensive, and even hazardous interventions.

摘要

母体姿势是进行无应激试验(NST)时需要考虑的最重要因素之一。它应该成为实践指南的一部分,因为合适的母体姿势可以减少测试相关的错误和假阳性结果。本研究旨在探讨 NST 期间不同母体姿势对母体血液动力学参数、满意度和胎儿胎心监护(CTG)模式的影响。这是一项在沙特阿拉伯纳季兰市 NST 诊所、门诊部门/母婴医院进行的准实验研究设计。该研究包括了 118 名处于妊娠晚期的低风险孕妇的便利样本。数据于 2020 年 1 月至 6 月收集。所有女性均在仰卧位、左侧卧位和半卧位三种体位下接受评估,比较 CTG 模式、母体血液动力学参数和满意度。研究结果表明,左侧卧位和半卧位的胎儿心率(FHR)更高,加速和胎儿运动更多,而仰卧位则较低,差异具有统计学意义。在三种体位下,FHR 变异性和 NST 反应性无统计学显著差异(P>0.05)。此外,母体心率、收缩压(BP)、舒张压和母体满意度在不同的母体体位之间存在统计学显著差异(P <0.05)。本研究得出结论,左侧卧位和半卧位与更有利的 CTG 模式、母体血液动力学参数和满意度相关,优于仰卧位。NST 测试期间应标准化左侧卧位和半卧位,以减少医护人员之间的实际差异,从而可能减少不必要的、昂贵的甚至危险的干预措施的需要。

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