夜间12小时尿E3/C比率与胎心率试验进行产前监护的评价

EVALUATION OF THE OVERNIGHT 12-HOUR URINE E3/C RATIO AND FETAL HEART RATE FOR PRENATAL MONITORING

本文回顾性地分析我院自1982年12月至1987年1月应用夜间12小时尿E3/C比率(E3/C)和胎心率(FHR)试验对793例晚期孕妇进行产前监护的结果。检测结果显示:1.FHR试验纠正E3/C的假阳性率为13.7%(93/677);2.E3/C对FHR结果可疑的116例中,有81例(70%)胎儿预测到正确的结果;3.两种监护指标均异常时围产儿的发病率为83.7%(36/43),死亡率为70%(3/43),较正常者2‰,1/462)增高35倍;4.两项测试指标均正常者,围产儿于7天内死亡的危险率为0.13(1/793)。提示E3/C可作为第一线的产前监护测定,若E3/C为低值,则再作FHR监护试验。尤其是在中、重度妊娠高血压综合征中,这两种监护指标的联合应用更可提高产前监护的正确率。

The overnight 12-hour urine estriol/creatinine ratio(E3/C)and fetal heart rate(FHR)test were used for prenatal monitoring in 793 late pregnancies from Dec 1982 to Jan 1987.The results revealed:1.FHR corrected the false positive rate of E3/C as much as 13.7%(93/677);2.E3/C gave reliable results in prenatal prediction in 81(70%)of the 116 cases suspected of abnormal FHR;3.When both tests were abnormal the incidence of poor perinatal results reached as high as 83.7%(36/43).The perinatal mortality in patients with abnormal values by both methods was 35 times higher than that in patients with normal results in both tests;4.The risk of death in utero within a week of negative FHR test and normal E3/C was only 0.13%(1/793).It is suggested that the E3/C may be used as the first choice test for perinatal monitoring.If E3/C value is lower than normal,FHR test should be performed especially in the moderate and severe hypertensive disorders of pregnancy.