Zusammenfassung
Diese Übersichtsarbeit befasst sich kritisch mit der Literatur zur Bewertung des Einflusses der intrapartalen Kardiotokographie (CTG) auf die klinischen Ergebnisse und ihre Bedeutung in der klinischen Praxis. Das elektronische fetale Monitoring (EFM) wurde vor 40 Jahren eingeführt. In Studien konnten keine eindeutig positiven Auswirkungen der CTG-Überwachung auf die Inzidenz der Zerebralparese, der perinatalen Mortalität und andere Indikatoren der Neugeborenengesundheit nachgewiesen werden. Der einzige klinisch relevante Vorteil der CTG ist die Reduktion der neonatalen Krämpfe. Die kontinuierliche Kardiotokographie ist mit einer Zunahme der Kaiserschnitte und der operativ-vaginalen Entbindungen assoziiert und hat eine hohe Falsch-positiv-Rate. Obwohl eindeutige Belege fehlen, die für die CTG sprechen, bleibt sie bis zur Entwicklung neuer Technologien ein sinnvolles Mittel zur Überwachung des fetalen Status unter der Geburt.
Abstract
This review critically appraises the literature to evaluate the impact of intrapartum cardiotocography (CTG) on clinical outcome and to revisit its role in clinical practice. Electronic fetal monitoring in labour (EFM) has been used for the last 40 years. Studies have failed to demonstrate clear benefits of the use of CTG monitoring on the incidence of cerebral palsy, perinatal mortality or other indicators of neonatal well-being. The only clinically relevant benefit from the use of CTG is a reduction of neonatal seizures. Continuous CTG is associated with an increase in caesarean sections and instrumental vaginal deliveries and has a high false positive rate. However, despite the lack of clear evidence to support its role, until new technologies are developed, CTG monitoring is a useful modality when monitoring fetal status during labour.
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Doumouchtsis, S., Arulkumaran, S. Einfluss der CTG-Überwachung auf das klinische Outcome. Gynäkologe 42, 336–342 (2009). https://doi.org/10.1007/s00129-008-2286-6
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DOI: https://doi.org/10.1007/s00129-008-2286-6
Schlüsselwörter
- Intrapartale Kardiotokographie
- Fetale Herzfrequenz
- Zerebralparese
- Neonatale Krämpfe
- Fetales EKG
- Sectiorate