胎心监护与脐血流测定联合应用对评价胎儿预后的价值

目的探讨无应激试验（NST）联合脐血流收缩期末最大血流速度/舒张期末最大血流速度（S/D比值）评价胎儿预后的价值。方法总结2007～2009年在本单位产科检查并分娩的高危孕妇350例,常规进行NST和S/D比值联合监护,并定期复查,将分娩前1周内最后一次检查结果与新生儿娩出后5min的Apgar评分作对照。结果单一的NST检查阴性预测价值达90.83%,阳性预测值仅53.64%,假阳性率达46.36%;联合检测阳性预测值为91.80%,阳性预测值明显提高,假阳性率仅为8.20%,其假阳性率明显降低。结论2种试验方法的阴性预测值较高,假阴性率较低;而阳性预检值较低,假阳性率较高。NST联合脐血流S/D比值可以弥补NST假阳性率过高的不足,减少不必要临床干预。

The value of estimation for fetus prognosis with fetal heart supervision and fetal umbilical artery Doppler velocimetry examination

Objective To explore the value of estimation for fetal prognosis with fetal heart supervision and fetal umbilical artery Doppler velocimetry examination.Methods The last findings at one week before labor in 350 cases of pregnant women were evaluated by non-stress test and umbilical artery flow velocity S/D ratio,then they were compared with Apgar scale at 5 min after the delivery.Results Negative predictive value was 90.83%,positive predictive value was only 53.64% and false-positive value was 46.36% in single non-stress test.Positive predictive value was 91.80% and false-positive value was only 8.20% in combination with two monitoring methods.Conclusion Negative predictive and false-positive values were high and false-negative and positive predictive values were low with these two monitoring methods.Combination of non-stress test with umbilical artery flow velocity S/D ratio can reduce false-positive value.