Golde S H, Montoro M, Good-Anderson B, Broussard P, Jacobs N, Loesser C, Trujillo M, Walla C, Phelan J, Platt L D
Am J Obstet Gynecol. 1984 Feb 1;148(3):269-73. doi: 10.1016/s0002-9378(84)80066-6.
Antepartum fetal surveillance methods applicable in a home glucose-monitored population of pregnant diabetic women have been evaluated. A testing sequence of nonstress heart rate testing, backed up by either the fetal biophysical profile or contraction stress testing employed at a twice weekly interval, in 107 outpatients was compared with the management of 140 historic control patients by weekly nonstress tests and daily plasma estriols. There were 617 of 672 (91.8%) reactive nonstress tests in outpatients compared to 566 of 626 (90.4%) reactive tests in hospitalized control patients. Of 13 contraction stress tests performed in the outpatient group, only one was positive. Although 2,670 estriol determinations were done on hospitalized control patients, none was used for outpatients. No losses were attributed to unexplained antenatal stillbirth in either group. A fetal biophysical score of 8 was found to be at least as reliable as a reactive nonstress test. Antenatal surveillance in the well-controlled, insulin-requiring diabetic woman can be safely achieved with a testing sequence that consists of twice weekly nonstress tests backed up by the fetal biophysical profile and contraction stress tests.
已对适用于在家中进行血糖监测的妊娠糖尿病女性群体的产前胎儿监测方法进行了评估。在107名门诊患者中，采用每周两次的无应激心率测试序列，并辅以胎儿生物物理评分或宫缩应激试验，将其与140名历史对照患者通过每周一次的无应激试验和每日血浆雌三醇进行的管理方式进行了比较。门诊患者中672次无应激试验有617次（91.8%）呈反应型，而住院对照患者中626次试验有566次（90.4%）呈反应型。门诊组进行的13次宫缩应激试验中，只有1次呈阳性。虽然对住院对照患者进行了2670次雌三醇测定，但门诊患者均未采用。两组均未出现因不明原因的产前死产导致的损失。发现胎儿生物物理评分为8至少与无应激试验呈反应型一样可靠。对于病情得到良好控制、需要胰岛素治疗的糖尿病女性，通过由每周两次的无应激试验辅以胎儿生物物理评分和宫缩应激试验组成的测试序列，可以安全地实现产前监测。
