Rühle W, von Ballestrem C L, Ertan A K, Schmidt W
Medizinische Universität zu Lübeck.
Ultraschall Med. 1993 Apr;14(2):79-84. doi: 10.1055/s-2007-1005221.
In a group of 79 pregnancies with highly abnormal Doppler-flow findings in foetal vessels the value of antepartal CTG criteria was evaluated in detail. In cases with absent enddiastolic flow (AEDF) the prognostical value was not further increased by antepartal pathological CTG findings. In cases with permanently normal antepartal CTG's, however, foetal outcome was fairly good (median duration of pregnancy 38 + 6 weeks, median foetal birth weight 2,545 grams, arterial pH < 7.20 in 9%). This was true also in the presence of pathological Doppler-flow findings except AEDF. In cases with pathological antepartal CTG findings in the antepartal course of pregnancy the loss of acceleration was most frequent (82%), followed by decreased frequency (53%) or narrowed amplitude (38%) of the foetal heart rate variation. Combination of both methods (Doppler sonography and CTG) is recommended clinically because the rate of uncertain findings can be reduced. Especially in cases with AEDF an active management would be justified before CTG's become pathological.
在一组79例胎儿血管多普勒血流结果高度异常的妊娠中，详细评估了产前CTG标准的价值。在舒张末期血流消失（AEDF）的病例中，产前病理性CTG结果并未进一步提高其预后价值。然而，在产前CTG始终正常的病例中，胎儿结局相当良好（妊娠中位数持续时间为38 + 6周，胎儿出生体重中位数为2545克，动脉血pH值<7.20的占9%）。除AEDF外，在存在病理性多普勒血流结果的情况下也是如此。在妊娠产前过程中出现病理性产前CTG结果的病例中，加速消失最为常见（82%），其次是胎儿心率变异频率降低（53%）或幅度变窄（38%）。临床上建议将两种方法（多普勒超声检查和CTG）结合使用，因为可以降低不确定结果的发生率。特别是在AEDF的病例中，在CTG出现病理性改变之前进行积极处理是合理的。
