CLINICAL USE OF DOPPLER ULTRASOUND IN PREGNANCY - INFORMATION FROM 6 RANDOMIZED TRIALS

被引：33

作者：

GILES, W

BISITS, A

机构：

[1] University of Newcastle, Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, John Hunter Hospital, Hunter Region, NSW

来源：

FETAL DIAGNOSIS AND THERAPY | 1993年 / 8卷 / 04期

关键词：

UMBILICAL ARTERY; DOPPLER; METAANALYSIS; RANDOMIZED TRIALS;

D O I：

10.1159/000263835

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

The objective of this report was to undertake an overview of the clinical utility of umbilical Doppler ultrasound in the management of high-risk pregnancies. The study is designed as a formal meta-analysis of 6 randomised trial reports selected by predetermined criteria and was performed at the Division of Reproductive Medicine, Newcastle University, Australia. A total of 6 randomised controlled trials amounted to 2,102 patients in the experimental (Doppler) group and 2,133 patients in the control group. All patients had high-risk pregnancies. The management of pregnancies with Doppler was compared to those with standard obstetric management (i.e. excluding Doppler). Main outcome measures were perinatal mortality in the form of intrauterine deaths as well as obstetric performance indicators including caesarean section, elective delivery, fetal distress in labour, antenatal admissions and admissions to Neonatal Intensive Care Unit. The meta-analysis shows, a significant reduction in perinatal mortality in the groups in which Doppler was used. Typical odds ratio was 0.5 [95% confidence intervals (CI) 0.34, 0.73]. The specific reduction in perinatal mortality occurred in intrauterine deaths in otherwise normally formed fetuses. The typical odds ratio was 0.54 with 95% CI 0.32, 0.89. This meta-analysis shows a significant reduction in overall perinatal mortality, specifically in the form of intrauterine deaths in otherwise normally formed babies.

引用

页码：247 / 255

页数：9

共 21 条

[1]

Stuart B., Drumm J., Fitzgerald D.E., Duignan N.M., Fetal blood velocity waveforms in normal pregnancy, Br J Obstet Gynaecol, 88, pp. 865-869, (1980)

[2]

Trudinger B.J., Giles W.B., Cook C.M., Bombadieri J., Fetal umbilical artery flow velocity waveforms and placental resistance: Clinical significance, Br J Obstet Gynaecol, 92, pp. 23-30, (1985)

[3]

Neilson J.P., Commentary. Doppler ultrasound, Br J Obstet Gynaecol, 94, pp. 929-934, (1987)

[4]

Thompson S.G., Pocock S.J., Can meta-analyses be trusted?, Lancet, 338, pp. 1127-1130, (1991)

[5]

Henry D.A., Wilson A., Meta-analysis. Part 1: An assessment of its aims, validity and reliability, Med J Aust, 156, pp. 31-38, (1992)

[6]

Effectiveness of intravenous thrombolytic treatment in acute myocardial infarction, Lancet, 1, pp. 397-401, (1986)

[7]

Randomised trial of IV streptokinase, oral aspirin, both, or neither among 17187 cases of suspected acute myocardial infarction, Lancet, 2, pp. 349-360, (1988)

[8]

Prendiville W., Elbourne D., Chalmers I., The effects of routine oxytocic administration in the management of the third stage of labour: An overview of the evidence from controlled trials, Br J Obstet Gynaecol, 95, pp. 3-16, (1988)

[9]

Prendiville W., Elbourne D., Chalmers I., The Bristol trial of the management of the third stage of labour, Br Med J, 297, pp. 1295-1300, (1988)

[10]

Neilson J.P., Doppler ultrasound study of umbilical artery waveforms in high risk pregnancies, Oxford Database of Perinatal Trials. Version 1.2 Disc Issue 6

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