OBJECTIVE:To determine the diagnostic value of fetal ST-segment analysis (STAN) in predicting neonatal acidosis. METHODS:The STAN S21 was used to monitor singleton fetuses in labor with abnormal FHR. Physicians later reviewed tracings to identify any ST events dictating intervention. Outcome measures were umbilical artery pH< or =7.15 and pH< or =7.05 at birth. The sensitivity, specificity, PPV, and NPV of a significant ST event to predict both outcomes were calculated. RESULTS:Analysis included 411 women. Sensitivity of a significant ST event for screening pH< or =7.15 (21.9%) was 38% (41/108), specificity 83% (252/303), PPV 45% (41/92) and NPV 79% (252/319), and for pH< or =7.05, it was (3.4%), 62.5% (10/16), 79% (313/395), 11% (10/92), and 98% (313/319), respectively. CONCLUSION:In a population with abnormal FHR in labor, STAN sensitivity is moderate (almost 40%) for predicting pH< or =7.15 and better (almost 60%) for more severe acidosis (pH< or =7.05).

译文

目的:确定胎儿ST段分析(STAN)对预测新生儿酸中毒的诊断价值。
方法:STAN S21用于监测胎心率异常的单胎胎儿。内科医生随后检查了示踪剂,以发现任何指示干预的ST事件。结果测量是出生时脐动脉pH <或= 7.15和pH <或= 7.05。计算了可预测两种预后的重大ST事件的敏感性,特异性,PPV和NPV。
结果:分析包括411名妇女。筛查pH <或= 7.15(21.9%)的重大ST事件的敏感性为38%(41/108),特异性83%(252/303),PPV 45%(41/92)和NPV 79%(252 / 319),对于pH <或= 7.05,分别为(3.4%),62.5%(10/16),79%(313/395),11%(10/92)和98%(313/319) , 分别。
结论:在FHR异常的人群中,STAN对预测pH <或= 7.15的敏感性为中度(近40%),对更严重的酸中毒(pH <或= 7.05)的敏感性为(近60%)。

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