背景:使用心电图(CTG)改善新生儿结局存在争议。医疗环境,主题,利用率,对于低收入和中等收入国家(LMICs),CTG的解释指南尚不清楚。
目的:评估和回顾CTG在LMICs研究中的应用,并提供关于CTG有效用于改善母婴结局的潜力的见解。
方法:数据库Medline,CINAHL,EMBASE,和Cochrane中央对照试验登记册(CENTRAL)在2023年9月之前搜索已发表和未发表的文献。
方法:确定了在LMIC中进行的出版物,根据世界银行2019年的经济名单;针对分娩中的孕妇;并侧重于CTG的利用和新生儿结局。
方法:筛选出版物,并删除了重复项。使用PRISMA-ScR指南进行了范围审查。
结果:搜索产生了1157个命中,其中67项研究纳入综述.在研究中,关于研究设置有相当大的差异和歧义,目标人群,利用率,定时,频率,和CTG的持续时间。虽然剖宫产率被广泛调查作为CTG本身的研究结果和其他技术对CTG的影响,其他有临床意义的结果,包括新生儿死亡率,没有很好的报道。
结论:在LMIC中使用CTG时发现了变化和歧义。由于证据有限,需要研究在LMIC的背景下检查CTG的可用性。
BACKGROUND: The use of cardiotocography (
CTG) to improve neonatal outcomes is controversial. The medical settings, subjects, utilizations, and interpretation guidelines of
CTG are unclear for low- and middle-income countries (LMICs).
OBJECTIVE: To assess and review
CTG use for studies identified in LMICs and provide insights on the potential for effective use of
CTG to improve maternal and neonatal outcomes.
METHODS: The databases Medline, CINAHL, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched for published and unpublished literature through September 2023.
METHODS: Publications were identified which were conducted in LMICs, based on the World Bank list of economies for 2019; targeting pregnant women in childbirth; and focusing on the utilization of CTG and neonatal outcomes.
METHODS: Publications were screened, and duplicates were removed. A scoping review was conducted using PRISMA-ScR guidelines.
RESULTS: The searches generated 1157 hits, of which 67 studies were included in the review. In the studies there was considerable variation and ambiguity regarding the study settings, target populations, utilizations, timing, frequency, and duration of CTG. While cesarean section rates were extensively investigated as an outcome of studies of CTG itself and the effect of additional techniques on CTG, other clinically significant outcomes, including neonatal mortality, were not well reported.
CONCLUSIONS: Variations and ambiguities were found in the use of
CTG in LMICs. Due to the limited amount of evidence, studies are needed to examine CTG availability in the context of LMICs.