Trudinger B J, Cook C M, Jones L, Giles W B
Br J Obstet Gynaecol. 1986 Feb;93(2):171-5. doi: 10.1111/j.1471-0528.1986.tb07882.x.
Antenatal fetal heart rate monitoring was compared with the study of umbilical artery flow velocity waveforms for the recognition of fetal compromise in 170 patients considered at high fetal risk. In 53 patients the infant had a 5-min Apgar score of less than 7 and/or a birthweight less than 10th centile of weight for gestation. Fetal heart rate traces were classified as reactive or non-reactive and also assessed with a modified Fischer score. The systolic/diastolic A/B ratio was measured in the umbilical artery waveform. Fetal compromise was more efficiently recognized by study of the umbilical artery waveforms. The sensitivity of assessment by umbilical artery waveforms was 60% compared with 17% and 36% respectively, for the two methods of scoring fetal heart rate traces. This was not associated with an increase in false-positive results as the predictive value of both positive (64% compared with 69 and 58%) and negative (83% compared with 72 and 75%) results was similar when umbilical artery waveform analysis was compared with the two methods of scoring fetal heart rate traces. Specificity was also similar (85% compared with 97 and 88%).
对170例被认为胎儿风险较高的患者，比较了产前胎儿心率监测与脐动脉血流速度波形研究在识别胎儿窘迫方面的效果。53例患者的婴儿5分钟阿氏评分低于7分和/或出生体重低于同孕周体重的第10百分位数。胎儿心率曲线分为反应型或无反应型，并采用改良的菲舍尔评分法进行评估。在脐动脉波形中测量收缩期/舒张期A/B比值。通过脐动脉波形研究能更有效地识别胎儿窘迫。脐动脉波形评估的敏感性为60%，而两种胎儿心率曲线评分方法的敏感性分别为17%和36%。这与假阳性结果的增加无关，因为将脐动脉波形分析与两种胎儿心率曲线评分方法进行比较时，阳性结果（分别为64%、69%和58%）和阴性结果（分别为83%、72%和75%）的预测价值相似。特异性也相似（分别为85%、97%和88%）。
