Grundy H, Freeman R K, Lederman S, Dorchester W
Obstet Gynecol. 1984 Sep;64(3):337-42.
Between September 1, 1976, and December 31, 1980, there were 4629 contraction stress tests performed at Women's Hospital, Memorial Hospital Medical Center of Long Beach, California. Forty-four (1.0%) of these tests were completely nonreactive. Eight of 3367 negative contraction stress tests (0.2%), 19 of 1124 equivocal contraction stress tests (1.7%), and 17 of 63 positive contraction stress tests (27.0%) were nonreactive. When compared with patients who had reactive tests, only those patients with a nonreactive, positive contraction stress test had significantly increased perinatal mortality and infants with low Apgar scores. Twelve percent of patients with nonreactive contraction stress tests had fetuses with congenital anomalies. Eighteen percent of patients with nonreactive tests were taking phenobarbital or other sedative drugs, and 45% of patients with nonreactive tests were hypertensive. Excluding anomalous fetuses, there were no perinatal deaths and no Apgar scores below 7 at five minutes in patients with nonreactive negative, or nonreactive equivocal, contraction stress tests as the worst test result. The hypothesis that the completely nonreactive negative contraction stress test as the worst test result is associated with increased perinatal mortality and morbidity could not be substantiated. Standardization of criteria for reactivity and interpretation of the contraction stress test using the entire testing period is desirable.
1976年9月1日至1980年12月31日期间，加利福尼亚州长滩纪念医院医疗中心妇女医院共进行了4629次宫缩应激试验。其中44次（1.0%）试验完全无反应。在3367次阴性宫缩应激试验中有8次（0.2%）、1124次可疑宫缩应激试验中有19次（1.7%）、63次阳性宫缩应激试验中有17次（27.0%）无反应。与试验有反应的患者相比，只有那些无反应、阳性宫缩应激试验的患者围产期死亡率显著增加，且阿氏评分低的婴儿较多。无反应宫缩应激试验的患者中有12%的胎儿患有先天性异常。无反应试验的患者中有18%正在服用苯巴比妥或其他镇静药物，无反应试验的患者中有45%患有高血压。排除异常胎儿后，以无反应阴性或无反应可疑宫缩应激试验作为最差试验结果的患者中，没有围产期死亡，且5分钟时阿氏评分均不低于7分。完全无反应阴性宫缩应激试验作为最差试验结果与围产期死亡率和发病率增加相关的假设无法得到证实。使用整个测试期对宫缩应激试验的反应性标准和解读进行标准化是可取的。
