目的:总结现有证据,对产前胎儿健康监测(FHS)提出建议,以发现围产期危险因素和潜在的胎儿代偿失调,及时进行干预,预防围产期发病和/或死亡。
方法:有或没有母亲的孕妇,胎儿,或产前胎儿代偿失调的妊娠相关围产期危险因素。
方法:要使用基本和/或高级产前检查方式,基于潜在胎儿代偿失调的危险因素。
结果:早期发现潜在的胎儿代偿失调,可以采取干预措施,支持胎儿适应以维持健康或加快分娩。
结果:具有确定的围产期危险因素的孕妇的产前FHS可能会减少不良结局的机会。鉴于高的假阳性率,FHS可能会增加不必要的干预措施,这可能会导致伤害,包括父母的焦虑,早产或手术分娩,和增加使用卫生保健资源。基于循证实践的监测方案的优化可以改善围产期结局并减少伤害。
方法:Medline,PubMed,Embase,从开始到2022年1月,使用医学主题词(MeSH)和与怀孕相关的关键词搜索了Cochrane图书馆,胎儿监护,胎动,死产,妊娠并发症,还有胎儿超声检查.本文件是对证据的抽象,而不是方法学审查。
方法:作者使用建议分级评估对证据质量和建议强度进行了评估,开发和评估(等级)方法。见在线附录A(表A1的定义和A2的强和弱的建议的解释)。
■所有为产科患者提供护理或教育的医疗保健团队成员,包括母体胎儿医学专家,产科医生,家庭医生,助产士,护士,执业护士,和放射科医生。
结论:建议。
To summarize the current evidence and to make recommendations for antenatal fetal health surveillance (FHS) to detect perinatal risk factors and potential fetal decompensation in the antenatal period and to allow for timely intervention to prevent perinatal morbidity and/or mortality.
Pregnant individuals with or without maternal, fetal, or pregnancy-associated perinatal risk factors for antenatal fetal decompensation.
To use basic and/or advanced antenatal testing modalities, based on risk factors for potential fetal decompensation.
Early identification of potential fetal decompensation allows for interventions that may support fetal adaptation to maintain well-being or expedite delivery.
Antenatal FHS in pregnant individuals with identified perinatal risk factors may reduce the chance of adverse outcomes. Given the high false-positive rate, FHS may increase unnecessary interventions, which may result in harm, including parental anxiety, premature or operative birth, and increased use of health care resources. Optimization of surveillance protocols based on evidence-informed practice may improve perinatal outcomes and reduce harm.
Medline, PubMed, Embase, and the Cochrane Library were searched from inception to January 2022, using medical subject headings (MeSH) and key words related to pregnancy, fetal monitoring, fetal movement, stillbirth, pregnancy complications, and fetal sonography. This document represents an abstraction of the evidence rather than a methodological review.
The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online Appendix A (Tables A1 for definitions and A2 for interpretations of strong and weak recommendations).
All health care team members who provide care for or education to obstetrical patients, including maternal fetal medicine specialists, obstetricians, family physicians, midwives, nurses, nurse practitioners, and radiologists.
RECOMMENDATIONS.