[Non-reactive pattern diagnosed by ultrasonic Doppler fetal actocardiogram and outcome of the fetuses with non-reactive pattern].
The accuracy of diagnosis by means of ultrasonic Doppler fetal actocardiogram in non-stress test (NST) was examined in 100 fetuses at 32 to 42 weeks of gestation. Fourteen fetuses were diagnosed as non-reactive by conventional NST which monitored fetal heart rate, but only 4 of the 14 fetuses were found to be "non-reactive" when the fetal actocardiogram was used. Thus the false positive rate obtained with conventional NST in judging the non-reactive pattern was 71.4% (10/14). We next examined the outcome for 25 fetuses (including 20 IUGR cases) with a "non-reactive pattern" who were diagnosed by fetal actocardiogram. Fetal distress occurred in 19 of these fetuses (76.0%), and mostly developed within 5 days after the diagnosis of "non-reactive pattern". The outcome for 20 IUGR fetuses with a "non-reactive pattern" was compared with that for fetuses with a "reactive pattern". IUGR fetuses which were "non-reactive" had a significantly higher fetal distress morbidity rate, and higher cesarean section rate. The sensitivity and specificity of the prediction of the development of fetal distress in IUGR fetuses with a "non-reactive pattern" were 81.0% and 84.2%, respectively. The present results strongly suggest the need to use the ultrasonic Doppler fetal actocardiogram at the time of NST after 32 weeks of gestation.
Teshima
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Department of Obstetrics and Gynecology, Faculty of Medicine, Tottori University, Yonago.
D015148:Cardiotocography / Q000379:methods*; D002585:Cesarean Section; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis*; D005316:Fetal Distress / Q000175:diagnosis; D005317:Fetal Growth Retardation / Q000175:diagnosis; D006340:Heart Rate, Fetal / Q000502:physiology*; D006801:Humans; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011379:Prognosis; D016216:Ultrasonography, Prenatal