Petrović O, Frković A, Matejcić N
Department of Obstetrics and Gynecology, University of Rijeka, Croatia.
Int J Gynaecol Obstet. 1995 Jul;50(1):11-5. doi: 10.1016/0020-7292(95)02392-p.
To determine the influence of the non-stress test (NST) on the efficiency of the fetal biophysical profile (FBP) and to test the clinical usefulness of the FBP and its combination with vibratory acoustic stimulation (VAS) in managing high-risk pregnancies.
One hundred twenty fetuses of preeclamptic patients were included in a prospective study. Five standard variables of the FBP were observed ultrasonically following NST. In cases of non-reactive NST, external VAS was applied and the FBP score calculated and compared with the FBP score before VAS.
Of 120 calculated FBPs, 102 (85%) had normal profile scores before VAS and 104 (86.7%) after VAS. No statistically significant difference was found. The sensitivity, specificity, and positive and negative predictive values of the FBP score in predicting poor perinatal outcome were 94.7%, 94.4%, 75% and 99%, respectively. VAS produced a high conversion (58.8%) of non-reactive NST to reactive fetal heart rate pattern. The false-negative rate of the FBP score was 9.8 per 1000, which did not increase after VAS.
The efficiency of the FBP score was not significantly improved by VAS, although a high conversion of non-reactive to reactive NST was produced. The FBP with its three 'acute biophysical variables' was found to be an accurate method of antepartum assessment even without an NST. The low incidence of perinatal complications among patients with normal FBP scores, permits the conservative management of preterm high-risk pregnancies.
确定无应激试验（NST）对胎儿生物物理评分（FBP）效率的影响，并测试FBP及其与振动声刺激（VAS）联合应用在高危妊娠管理中的临床实用性。
120例先兆子痫患者的胎儿纳入一项前瞻性研究。在NST后超声观察FBP的五个标准变量。对于NST无反应的病例，应用外部VAS，计算FBP评分并与VAS前的FBP评分进行比较。
在120次计算的FBP中，VAS前102例（85%）的评分正常，VAS后104例（86.7%）评分正常。未发现统计学上的显著差异。FBP评分预测围产期不良结局的敏感性、特异性、阳性和阴性预测值分别为94.7%、94.4%、75%和99%。VAS使无反应的NST转为有反应的胎心率模式的转化率很高（58.8%）。FBP评分的假阴性率为每1000例中有9.8例，VAS后未增加。
尽管VAS使无反应的NST转为有反应的转化率很高，但FBP评分的效率并未因VAS而显著提高。发现具有三个“急性生物物理变量”的FBP即使在没有NST的情况下也是一种准确的产前评估方法。FBP评分正常的患者围产期并发症发生率低，允许对早产高危妊娠进行保守管理。
