Mason G C, Lilford R J, Porter J, Nelson E, Tyrell S
Department of Obstetrics, St James's University Hospital, Leeds, UK.
Br J Obstet Gynaecol. 1993 Feb;100(2):130-3. doi: 10.1111/j.1471-0528.1993.tb15207.x.
To help answer the question: should Doppler ultrasound of the umbilical circulation be made available to all pregnant women as part of their routine antenatal care?
A randomised trial.
St James's University Hospital, Leeds.
2025 low risk primigravid women.
Obstetric intervention rates and short term neonatal morbidity.
The incidence of abnormal Doppler was low (1.7%) with complete absence of end diastolic flow in only 0.3% of cases. No significant differences could be demonstrated between control and study women in any of the outcomes measured.
This study did not demonstrate any benefit or harm from Doppler ultrasound as a routine screening test for all low risk women, whereas our previous studies have suggested that it is useful in high risk pregnancies. Any marginal returns on extending access to Doppler ultrasound from high risk to all women must be small. Since this test has excellent performance characteristics (sensitivity and specificity) for the prediction of fetal hypoxia and acidosis our results call into question the cost to benefit ratio of all tests designed to predict these outcomes in low risk women.
帮助回答以下问题：脐循环的多普勒超声检查是否应作为所有孕妇常规产前检查的一部分提供给她们？
一项随机试验。
利兹圣詹姆斯大学医院。
2025名低风险初产妇。
产科干预率和短期新生儿发病率。
异常多普勒检查的发生率较低（1.7%），仅0.3%的病例完全没有舒张末期血流。在测量的任何结果中，对照组和研究组女性之间均未显示出显著差异。
本研究未证明对所有低风险女性进行多普勒超声常规筛查有任何益处或危害，而我们之前的研究表明其在高危妊娠中有用。将多普勒超声检查从高危女性扩大到所有女性所获得的任何边际收益必定很小。由于该检查在预测胎儿缺氧和酸中毒方面具有出色的性能特征（敏感性和特异性），我们的结果对所有旨在预测低风险女性这些结果的检查的成本效益比提出了质疑。
