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临床实践中心电图描记图的计算机分析及32年后的SisPorto系统:技术、生理病理学和临床研究

Computerized analysis of cardiotocograms in clinical practice and the SisPorto system thirty-two years after: technological, physiopathological and clinical studies.

作者信息

Bernardes João

机构信息

Head of the Department of Gynecology Obstetrics and Pediatrics, Faculdade de Medicina da Universidade do Porto, Portugal.

Senior Consultant of Centro Hospitalar Universitário de São João, Porto, Portugal.

出版信息

J Perinat Med. 2022 Sep 5;51(1):145-160. doi: 10.1515/jpm-2022-0406. Print 2023 Jan 27.

Abstract

OBJECTIVES

The objective of this study is to present the why, what and how about computerized analysis of cardiotocograms (cCTG) and the SisPorto system for cCTG.

CONTENT

A narrative review about cCTG and the SisPorto system for cCTG is presented. The meta-analysis of randomized controlled trials (RCT) performed so far have evidenced that cCGT compared to traditional CTG analysis may save time spent in hospital for women, in the antepartum period, and is objective with at least equivalent results in maternal and perinatal outcomes, both in the ante and intrapartum periods. The SisPorto system for cCTG closely follows the FIGO guidelines for fetal monitoring. It may be used both in the ante and intrapartum periods, alone or connected to a central monitoring station, with simultaneous monitoring of fetal and maternal signals, not only in singletons but also in twins. It has been assessed in technical, physiopathological and clinical studies, namely in one large multicentric international RCT during labor and two meta-analysis.

SUMMARY AND OUTLOOK

There is evidence that cCTG may be useful in clinical practice with advantages compared to traditional CTG analysis, although without clear impact on the decrease of preventable maternal and perinatal mortality and morbidity. More studies are warranted, namely on technical improvements and assessment in larger studies in a wider range of clinical settings.

摘要

目的

本研究的目的是阐述进行计算机化分析胎心监护图(cCTG)及SisPorto系统用于cCTG的原因、内容和方式。

内容

本文对cCTG及SisPorto系统进行了叙述性综述。迄今为止进行的随机对照试验(RCT)的荟萃分析表明,与传统的CTG分析相比,cCGT可以节省女性产前在医院的时间,并且是客观的,在产前和产时的母婴和围产期结局方面至少具有同等结果。用于cCTG的SisPorto系统严格遵循FIGO胎儿监测指南。它可用于产前和产时,可单独使用或连接到中央监测站,同时监测胎儿和母亲的信号,不仅适用于单胎,也适用于双胎。它已经在技术、生理病理和临床研究中进行了评估,即在一项大型多中心国际分娩RCT和两项荟萃分析中进行了评估。

总结与展望

有证据表明,与传统的CTG分析相比,cCTG在临床实践中可能有用,尽管对降低可预防的母婴和围产期死亡率及发病率没有明显影响。需要进行更多的研究,特别是在技术改进以及在更广泛的临床环境中进行更大规模研究的评估方面。

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