在瑞典修订CTG分类和更新乳酸计后,胎儿血液采样频率,分娩方式和新生儿结局:一项观察性研究
Klara Gröndal1, Erika Gyllencreutz1,2, Stina Wretler1,3
1Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Acta obstetricia et gynecologica Scandinavica
|February 7, 2025
概括
在瑞典实施修订的心脏病学分类 (CTG) 和新的乳酸计导致胎儿血液采样 (FBS) 显著下降. 虽然受试胎儿的酸血和紧急剖腹产增加,但整体不良结果仍然很低.
科学领域:
- 产科和妇科 产科和妇科
- 胎儿监测 胎儿监测 胎儿监测
- 新生儿结局的结果.
背景情况:
- 瑞典在2017年实施了经过修订的心电图学 (CTG) 分类,以及更新的乳酸计 (Lactate Pro 2TM),产生更高的读数.
- 这些变化需要新的胎儿血液采样 (FBS) 协议,并促使对其对分娩方式和新生儿结局的影响进行调查.
研究的目的:
- 在实施修订的CTG分类和新的乳酸计后,调查胎儿血液采样 (FBS) 的频率,分娩方式和新生儿结局.
- 评估这些变化对酸血和新生儿不良结果的比例的影响,假设样本中胎儿的发病率增加.
主要方法:
- 一项基于人口的队列研究分析了斯德哥尔摩-戈特兰 (2014-2015年和2018-2019年) 的电子病历.
- 包括单独怀孕>34周的头部表现,比较两个时期的样本和非样本胎儿的结果.
主要成果:
- 胎儿血液采样 (FBS) 频率在变化后显著下降 (11.9%至8.2%).
- 在FBS中,酸血的比例在样本胎儿 (7.1%至12.5%) 和总人口 (0.8%至1.0%) 中增加.
- 由于胎儿痛苦而导致的立即剖腹产在抽样胎儿中增加 (2.0%至3.1%),而在抽样和非抽样组中,低Apgar分数变得更频繁.
结论:
- 修订后的CTG分类和新的乳酸计大大减少了FBS的使用.
- 尽管受试胎儿的酸血和紧急剖腹产增加,但这些不良事件在整体劳动人口中仍然很低.
- 在实施后,在样本和非样本新生儿中,观察到较低的Apgar分数更频繁.
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