重新构建产前和产后监测
Lawrence D Devoe1, David W Britt2, Mark I Evans3
1Department of Obstetrics and Gynecology at the Medical College of Georgia at Augusta University, Augusta, GA, USA; Fetal Medicine Foundation of America, USA.
Best practice & research. Clinical obstetrics & gynaecology
|November 5, 2024
概括
电子胎儿监测 (EFM) 已经发展. 一种新的胎儿储备指数 (FRI) 方法改善了在分娩期间早期检测胎儿风险,可能减少不良结果和不必要的剖腹产.
科学领域:
- 产科和妇科 产科和妇科
- 围产儿医学 围产儿医学
- 胎儿生理学 胎儿生理学
背景情况:
- 电子胎儿监测 (EFM) 最初旨在减少死产,这一目标在很大程度上实现了.
- 随后使用EFM减少神经系统损伤的努力,包括脑,在50多年中产生了相互矛盾的数据.
- 剖腹产率增加了六倍,与更高的并发症和成本相关,尽管EFM在检测胎儿痛苦方面的局限性.
研究的目的:
- 审查产前和产后胎儿监测技术的演变.
- 介绍一种新的,重新设计的胎儿监测方法,称为胎儿储备指数 (FRI).
- 展示FRI在改善早期发现胎儿风险和指导干预方面的潜力.
主要方法:
- 对多代产前检测方案的审查.
- 开发和应用胎儿储备指数 (FRI) 用于产后监测.
- FRI量化了胎儿心率,变化,加速和减速,并结合了子宫活动和孕产妇/胎儿风险因素.
- 最初的版本 (1.0) 将所有参数权重均等.
主要成果:
- 在病理生理学中,FRI可以更好地及早地识别胎儿风险.
- 与传统方法相比,这有助于进行不那么突然和戏剧性的干预.
- 产后早期被认为是一个常见不被认可的风险阶段.
结论:
- 胎儿储备指数 (FRI) 与主观的EFM类别系统相比,是一个显著的进步.
- FRI提供了一种更客观,更可量化的方法,用于产后胎儿监测.
- 设想从产前期到产后评估的护理连续性,以获得最佳的产周结果.
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