Manning F A, Platt L D, Sipos L, Keegan K A
Am J Obstet Gynecol. 1979 Oct 15;135(4):511-5. doi: 10.1016/0002-9378(79)90442-3.
Three hundred ninety-eight observations of fetal breathing movements (FBM) and the nonstress test (NST) were made in 223 patients. The presence of FBM was noted in a significantly higher proportion of tests with a reactive NST (88%) than a nonreactive NST (67%). Conversely, a significantly higher proportion of tests were reactive when FBM were present (82.6%) than when FBM were absent (49%). A significant relationship existed betweeen either test and the outcome of pregnancy as judged by the five minute Apgar score or the incidence of fetal distress in labor. Combining two normal tests did not improve the accuracy in predicting outcome; but the combination of both tests, when abnormal, produced a significant improvement in predicting fetuses likely to have an abnormal outcome. The combination of the normal with the abnormal test had a predictive accuracy similar to a single normal test in predicting a normal five-minute Apgar. This combination was associated with an incidence of fetal distress in labor intermediate between that seen with either the normal or abnormal test when alone. Neither a single test nor the combination of tests was helpful in identifying the small-for-gestational age (SGA) infants. These data indicate antepartum fetal evaluation may be improved when more than one biophysical variable is used.
对223例患者进行了398次胎儿呼吸运动（FBM）和无应激试验（NST）观察。在反应型NST的试验中，FBM出现的比例（88%）显著高于无反应型NST（67%）。相反，当存在FBM时，试验反应型的比例（82.6%）显著高于不存在FBM时（49%）。根据5分钟阿氏评分或分娩时胎儿窘迫的发生率判断，两种试验中的任何一种与妊娠结局之间均存在显著关系。两种正常试验相结合并不能提高预测结局的准确性；但当两种试验均异常时，在预测可能有异常结局的胎儿方面有显著改善。正常试验与异常试验相结合在预测正常5分钟阿氏评分方面的预测准确性与单一正常试验相似。这种组合与分娩时胎儿窘迫的发生率相关，介于单独进行正常试验或异常试验时的发生率之间。无论是单一试验还是试验组合，在识别小于胎龄（SGA）婴儿方面均无帮助。这些数据表明，当使用多个生物物理变量时，产前胎儿评估可能会得到改善。
