Mother Infant Research Institute, Tufts Medical Center, Boston, Massachusetts.
Tufts University School of Medicine, Boston, Massachusetts.
Am J Perinatol. 2024 May;41(S 01):e2978-e2984. doi: 10.1055/a-2184-1294. Epub 2023 Sep 29.
This study aimed to measure the proportion of patients needing urgent clinical follow-up after an abnormal outpatient nonstress test (NST). We further sought to capture the patient perspective on the acceptability of performing NSTs at home.
A retrospective cohort study was performed over a 2-year period to determine the frequency of abnormal NSTs in a hospital-based, antepartum testing unit in patients greater than or equal to 32 weeks' gestation. The proportion of patients who delivered within 24 hours of an abnormal NST was also determined. A cross-sectional, web-based patient survey was conducted to obtain insight into the patient's comfort level with potentially performing NSTs at home.
The chart review yielded 665 patients who underwent 2,122 NSTs at greater than or equal to 32 weeks. Of the 2,122 NSTs, 111 were categorized as abnormal and required urgent clinical follow-up, or 5.2% (95% confidence interval [CI] 4.3, 6.3%). Of the 665 patients, 13 delivered within 24 hours of an abnormal NST, or 2.0% (95% CI 1.0, 3.3%). In the web-based survey, the proportion of respondents who would feel comfortable or very comfortable conducting NSTs at home was 87/125, or 69.6% (95% CI 60.9, 77.1%).
This study revealed that 5.2% of NSTs performed in a hospital-based antepartum testing unit were abnormal and required urgent clinical follow-up. Of the patients being followed in the antepartum testing unit, 2.0% delivered within 24 hours of an abnormal NST. The majority of the survey respondents indicated they would feel comfortable performing NSTs at home. The present study adds important information regarding the risks and benefits of NSTs at home.
· Telehealth for NSTs offers advantages over in-person NSTs.. · The proportion of NSTs that need urgent follow-up was 5.2%.. · A majority of patients are interested in telehealth for NSTs.. · Guidelines are needed before adoption of telehealth for NSTs..
本研究旨在测量门诊无应激试验（NST）异常后需要紧急临床随访的患者比例。我们还试图了解患者对在家进行 NST 的可接受程度。
在一项为期 2 年的回顾性队列研究中，我们确定了大于或等于 32 周妊娠的医院产前检查单位中异常 NST 的频率。还确定了在异常 NST 后 24 小时内分娩的患者比例。进行了一项横断面、基于网络的患者调查，以了解患者对在家中进行潜在 NST 的舒适度。
图表审查得出了 665 名在大于或等于 32 周时接受了 2122 次 NST 的患者。在 2122 次 NST 中，有 111 次被归类为异常，需要紧急临床随访，占 5.2%（95%置信区间[CI]4.3，6.3%）。在 665 名患者中，有 13 名在异常 NST 后 24 小时内分娩，占 2.0%（95%CI1.0，3.3%）。在基于网络的调查中，愿意在家中进行 NST 感到舒适或非常舒适的受访者比例为 87/125，占 69.6%（95%CI60.9，77.1%）。
本研究表明，在医院产前检查单位进行的 NST 中，有 5.2%异常并需要紧急临床随访。在产前检查单位接受随访的患者中，有 2.0%在异常 NST 后 24 小时内分娩。大多数调查受访者表示，他们在家中进行 NST 会感到舒适。本研究提供了关于在家中进行 NST 的风险和益处的重要信息。
· NST 的远程医疗提供了优于面对面 NST 的优势。· 需要紧急随访的 NST 比例为 5.2%。· 大多数患者对 NST 的远程医疗感兴趣。· 在采用 NST 的远程医疗之前需要指南。
