■本系统评价的目的是严格评估妊娠晚期脑胎盘比率在预测不良围产期结局和降低死胎率方面的功效。
■使用CINAHL进行文献检索,EMBASE,EMCARE,MEDLINE和PubMed,包括系统评价,从开始到2020年7月的回顾性和前瞻性研究利用PRISMA清单和流程图。数据显示灵敏度,提取并合成包括95%置信区间(CI)的特异性和比值比(OR).
■最初,1226项研究被确定,9项研究符合纳入标准.样本量范围从491到9772次怀孕。在检测胎儿死亡的所有独立变量中,脑胎盘比率具有最强的诊断准确性(平均敏感性和特异性;79%和78%)。脑胎盘比率,然而,在预测手术分娩(平均敏感度和特异度;59%和82%)或预期进入新生儿重症监护病房(平均敏感度和特异度;55%和74%)方面表现不佳.
■这项研究的结果表明,在检测不良围产期结局时,妊娠晚期的脑胎盘比率已被证明具有中等至高的诊断价值,特别是胎儿死亡。
■脑胎盘比率有可能作为减少不良围产期结局的诊断工具,特别是胎儿死亡,有助于降低死胎率。主要研究限制涉及纳入研究中的异质性,特别是在致盲方面。
UNASSIGNED: The aim of this systematic
review is to critically assess the efficacy of the cerebroplacental ratio performed in the third trimester at predicting adverse perinatal outcomes and reducing stillbirth rates.
UNASSIGNED: The literature search was performed using CINAHL, EMBASE, EMCARE, MEDLINE and PubMed including systematic reviews, retrospective and prospective studies from inception until July 2020 utilising the PRISMA checklist and flowchart. Data displaying sensitivities, specificity and odds ratios (OR) to include 95% confidence interval (CI) were extracted and synthesised.
UNASSIGNED: Initially, 1226 studies were identified, and nine studies met the inclusion criteria. Sample sizes ranged from 491 to 9772 pregnancies. The cerebroplacental ratio had the strongest diagnostic accuracy of all of the independent variables for detecting fetal demise (mean sensitivity and specificity; 79% and 78%). The cerebroplacental ratio, however, did not perform as favourably at predicting operative delivery (mean sensitivity and specificity; 59% and 82%) or anticipating admission to the neonatal intensive care unit (mean sensitivity and specificity; 55% and 74%).
UNASSIGNED: The results from this study showed that the cerebroplacental ratio within third trimester pregnancies has been proven to have moderate to high diagnostic value when detecting adverse perinatal outcomes, in particular fetal demise.
UNASSIGNED: Cerebroplacental ratio has the potential as a diagnostic tool to reduce adverse perinatal outcomes, in particular fetal demise and help reduce stillbirth rates. The main study limitation involved heterogeneity within the included studies, in particular with a regard to blinding.