A randomized controlled trial of a new fetal acoustic stimulation test for fetal well-being

OBJECTIVES: Our purpose was to determine (1) whether a fetal acoustic stimulation test results in more palpable fetal movement compared with a mock test (control) and (2) whether palpated fetal movements after a fetal acoustic stimulation test are accompanied by a reactive nonstress test.STUDY DESIGN: In a randomized controlled trial we studied women seen in the labor and delivery suite for various indications. Women were excluded for multiple gestation, <31 weeks' gestational age, treatment with magnesium sulfate or narcotics, or ruptured membranes. Informed consent was obtained from eligible women, who were then randomized to a test or control group. We placed an acoustic stimulator on the abdomen of each woman, but only the test group was stimulated. We assessed fetal movement by a grading system: 0 = no fetal movement felt by patient or tester, 1 = fetal movement felt by patient only, 2 = fetal movement felt by tester, 3 = visual movement seen by tester. A positive fetal acoustic stimulation test result was defined as one with any fetal movement felt or seen by the tester (grades 2 or 3). We then performed a nonstress test. We compared rates of a positive fetal acoustic stimulation test in the test and control groups with the χ² test. A p value <0.05 was considered significant.RESULTS: We randomized 297 women to the test group and 280 women to the control (mock test) group. Of women tested with the fetal acoustic stimulation test, 81% had fetal movement by palpation or visualization (grades 2 or 3) compared with 19% of the control group (p < 0.0001, odds ratio 19.29, 95% confidence interval 12.42 to 30.07). Of the test group, 283 (95%) had a reactive nonstress test and 14 (5%) had nonreactive tests; the control group had 267 (95%) reactive and 13 (5%) nonreactive nonstress tests. Of 242 patients in the test group with a positive fetal acoustic stimulation test, 236 (98%) had a reactive nonstress test. Of those in the test group with fewer than three contractions per 10 minutes, 164 (89%) had a positive fetal acoustic stimulation test. Of these, 162 (99%) had a reactive nonstress test.CONCLUSION: The fetal acoustic stimulation test evokes significantly more palpated or visualized fetal movement than in controls. Palpated or visualized fetal movement after acoustic stimulation was almost always accompanied by a reactive nonstress test. (Am J Obstet Gynecol 1997;176:1386-8.)     

隔药灸治疗寒凝型痛经的疗效及对PGF2α、PGE2影响

目的探讨隔药灸治疗寒凝型痛经的作用机制。方法把60例寒凝型痛经患者按随机数字表分为两组,每组30例,隔药灸组采用隔药灸神阙穴,西药组采用内服西药,并设正常空白组30例不作任何治疗。结果隔药灸组总有效率（96．7％）优于西药组（83．3%）（P〈0．05）。隔药灸组治疗后PGF2α、PGEz与西药组比较差异有统计学意义（P〈0．01）。结论隔药灸治疗寒凝型痛经的疗效机制与调节PGF2α及PGE2有关,即可降低经期外周血PGF2α含量,升高PGE2含量。     

新疆一枝蒿新倍半萜成分——一枝蒿酮酸的结构

从新疆一枝蒿(Artemisia rupestris L.)脂溶性部分分得一种新倍半萜晶体,根据紫外光谱,红外光谱、质谱,核磁共振氢谱及碳谱等分析,确定了结构,命名为一枝蒿酮酸。