住院心脏图谱:一个随机对照试验.
Lawrence Impey1, Margaret Reynolds, Kathryn MacQuillan
1Oxford Feto-Maternal Medicine Unit, Women's Centre, John Radcliffe Hospital, Headington, Oxford, UK. lawrence.impey@orh.nhs.uk
Lancet (London, England)
|February 14, 2003
概括
在低风险怀孕中,20分钟的常规入院心脏病造影并不能改善新生儿的结果. 这种胎儿监测方法在新生儿发病率或死亡率上没有显著的差异,与间歇性听诊相比.
科学领域:
- 产科和妇科 产科和妇科
- 围产儿医学 围产儿医学
- 胎儿监测 胎儿监测 胎儿监测
背景情况:
- 输入心脏图谱是一种常见的做法,用于识别需要在分娩期间持续电子胎儿监测的怀孕.
- 这项研究旨在比较入院心脏图谱和间歇性胎儿心率听觉之间的新生儿结局.
研究的目的:
- 评估20分钟常规入院心脏图谱在改善低风险怀孕新生儿结局方面的有效性.
- 为了比较入院心脏图谱和间歇性听力学之间的中度至重度新生儿发病率和围产期死亡率的发生率.
主要方法:
- 一项随机对照试验涉及8580名低风险妇女,这些妇女被送往都柏林一家教学医院的分娩室.
- 参与者被分配到20分钟的入院心电图或通常的护理 (间歇性听力与持续监测,只有在临床上表明).
- 主要结局:中度至重度的新生儿发病率或围产期死亡率 (不包括重大先天性形);进行了治疗意图分析.
主要成果:
- 主要终点发生在入院心血管学组 (56/4298) 和常规护理组 (55/4282) 的1.3%的女性中,相对风险为1.01 (95% CI 0.70-1.47).
- 在其他新生儿发病率指数,剖腹产率 (RR 1.13),仪器分娩率 (RR 1.03),或表皮切割率 (RR 1.06) 中没有发现显著差异.
- 入院心脏图谱导致持续心脏图谱和胎儿血液采样的使用增加.
结论:
- 对于低风险怀孕的常规20分钟入院心脏图谱并不能改善新生儿的结果.
- 该研究表明,常规使用入院心脏图谱并不能改善新生儿健康,也不会导致手术分娩的显著增加,这可能是由于同时使用胎儿血液采样.
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