Vintzileos A M, Nochimson D J, Antsaklis A, Varvarigos I, Guzman E R, Knuppel R A
Department of Obstetrics, Gynecology, and Reproductive Sciences, RobertWood Johnson Medical School/St. Peter's Medical Center, University of Medicine and Dentistry of New Jersey, New Brunswick, USA.
Am J Obstet Gynecol. 1995 Oct;173(4):1021-4. doi: 10.1016/0002-9378(95)91320-3.
Our purpose was to compare continuous intrapartum electronic fetal heart rate monitoring with intermittent auscultation for detecting fetal acidemia at birth.
Data from a previously published randomized trial of electronic fetal heart rate monitoring versus intermittent auscultation were analyzed to identify any differences between the two methods in detecting fetal acidemia at birth. Fetal acidemia at birth was defined as the presence of cord blood arterial pH < 7.15.
A total of 1419 patients with umbilical cord blood acid-base measurements were identified, 739 in the electronic FHR monitoring group and 680 in the auscultation group. Electronic FHR monitoring had significantly better sensitivity (97% vs 34%, p < 0.001), lower specificity (84% vs 91%, p < 0.001), higher positive predictive value (37% vs 22%, p < 0.05), and higher negative predictive value (99.5% vs 95%, p < 0.001) in detecting fetal acidemia at birth. In addition, electronic FHR monitoring was significantly better in detecting all types of acidemia: metabolic (95.5% vs 26.5%, p < 0.001), mixed (95% vs 37.5%, p < 0.001), and respiratory (100% vs 41.5%, p < 0.001).
These data suggest that electronic FHR monitoring is superior to intermittent auscultation in detecting fetal acidemia at birth.
我们的目的是比较产时连续电子胎儿心率监测与间断听诊在出生时检测胎儿酸血症的效果。
分析了一项先前发表的关于电子胎儿心率监测与间断听诊的随机试验数据，以确定这两种方法在出生时检测胎儿酸血症方面的差异。出生时胎儿酸血症定义为脐血动脉pH值<7.15。
共确定了1419例有脐血酸碱测量值的患者，电子胎儿心率监测组739例，听诊组680例。在出生时检测胎儿酸血症方面，电子胎儿心率监测具有显著更高的敏感性（97%对34%，p<0.001）、更低的特异性（84%对91%，p<0.001）、更高的阳性预测值（37%对22%，p<0.05）和更高的阴性预测值（99.5%对95%，p<0.001）。此外，电子胎儿心率监测在检测所有类型的酸血症方面明显更好：代谢性（95.5%对26.5%，p<0.001）、混合型（95%对37.5%，p<0.001）和呼吸性（100%对41.5%，p<0.001）。
这些数据表明，在出生时检测胎儿酸血症方面，电子胎儿心率监测优于间断听诊。
