Fetal Non-reaktif non-stress test paterni takibinde fetal doppler ultrason veya çikolatanın yeri : Prospektif randomize kontrollü çalışma
Yıl 2022,
Cilt: 5 Sayı: 2, 85 - 91, 31.08.2022
Gökhan Karakoç
Serenat Yalçın
,
Hasan Eroglu
,
Halime Şen Selim
,
Kutlu Kurt
Mustafa Şengül
Aykan Yücel
Öz
Amaç: Bu çalışmanın amacı, 20 saniyelik MCA Doppler ultrasonografi ve bitter çikolatanın, non-stres test (NST) paternleri; anne tarafından hissedilen fetal hareketler ve sezaryen doğum oranlarına etkisini karşılaştırmaktır.
Yöntemler: 36-41 hafta arası reaktif olmayan NST paterni olan tekil gebelikler çalışmaya dahil edildi ve prospektif olarak Doppler ultrason, bitter çikolata ve müdahalesiz kontrol gruplarına randomize edildi. Hastaların 5. ve 30. dakikadaki NST'leri incelendi.
Bulgular: Anne tarafından hissedilen fetal hareketlerdeki iyileşme oranı gruplar arasında anlamlı farklılık göstermedi (p ˃ 0.05). Doppler grubunda 5. dakika reaktif NST oranı, takip ve çikolata grubuna göre anlamlı olarak daha yüksekti (p ˂ 0.05). Çikolatalı ve müdahalesiz kontrol grubunda 5. dakika reaktif NST oranı anlamlı farklılık göstermedi (p ˃ 0.05). 30. dakika NST'de, reaktif olmayan sonuçları olan hastalarda, Doppler grubunda diğer gruplara göre anlamlı derecede daha yüksek fetal distres oranları vardı (p ˂ 0.05).
Sonuç: Doppler uygulaması ile hastanede kalış süresinin ve buna bağlı olarak hastanın kaygısının azalacağını düşünüyoruz. Ayrıca yanlış tepkisizliği hızla düzelttiği için hasta fetal distres açısından daha dikkatli izlenmelidir.
Kaynakça
- 1. Xi Q, Du J, Liu X, et al. Clinical study on detecting false non-reactive of non-stress test by improved acoustic stimulation. Arch Gynecol Obstet. 2011; 284 (2): 271-4.
doi: 10.1007/s00404-010-1621-z
- 2. Black RS, Campbell S. Cardiotocography versus Doppler. Ultrasound Obstet Gynecol. 1997; 9 (3):148–51.
doi: 10.1046/j.1469-0705.1997.09030148.x.
- 3. Suwanrath C, Suntharasaj T. Sleep-wake cycles in normal fetuses. Arch Gynecol Obstet. 2010; 281 (3): 449–54.
doi: 10.1007/s00404-009-1111-3.
- 4. Paine LL, Strobino DM, Witter FR, et al. Population differences affect nonstress test reactivity. J Perinatol. 1991; 11 (1): 41–5.
- 5. Johnson MJ, Paine LL, Mulder HH, et al. Population differences of fetal biophysical and behavioral characteristics. Am J Obstet Gynecol. 1992; 166 (1): 138–42.
doi: 10.1016/0002-9378(92)91847-4.
- 6. Esin S. Factors that increase reactivity during fetal nonstress testing. Curr Opin Obstet Gynecol. 2014; 26 (2): 61-6.
doi: 10.1097/GCO.0000000000000050.
- 7. Miller FC, Skiba H, Klapholz H. The effect of maternal blood sugar levels on fetal activity. Obstet Gynecol. 1978; 52 (6):662–5.
- 8. Fatemi M, Ogburn PL Jr, Greenleaf JF. Fetal stimulation by pulsed diagnostic ultrasound. J Ultrasound Med. 2001; 20 (8): 883-9.
doi: 10.7863/jum.2001.20.8.883.
- 9. Miller DL, Quddus J. Diagnostic ultrasound activation of contrast agent gas bodies induces capillary rupture in mice. Proc Natl Acad Sci. 2000; 97 (18): 10179-84.
doi: 10.1073/pnas.180294397.
- 10. Nyman M, Barr M, Westgren M. A four-Year follow-up of hearing and develop-ment in children exposed in utero to vibroacoustic stimulation. Br J Obstet Gynaecol. 1992; 99 (8): 685-8.
doi: 10.1111/j.1471-0528.1992.tb13856.x.
- 11. Reeves MJ, Brandreth M, Whitby EH, et al. Neonatal cochlear function: measurement after exposure to acoustic noise during in utero MR imaging. Radiology 2010; 257 (3): 802-9.
doi: 10.1148/radiol.10092366.
- 12. Kafali H, Derbent A, Keskin E, et al. Effect of maternal anxiety and music on fetal movements and fetal heart rate patterns. J Matern Fetal Neonatal Med. 2011; 24 (3): 461-4.
doi: 10.3109/14767058.2010.501122.
- 13. Khooshideh M, Izadi S, Shahriari A, et al. The predictive value of ultrasound assessment of amniotic fluid index, biophysical profile score, nonstress test and foetal movement chart for meconium- stained amniotic fluid in prolonged pregnancies. J Pak Med Assoc. 2009; 59 (7): 471–4.
- 14. Esin S, Baser E, Cakir C, et al. Chocolate or orange juice for non-reactive non-stress test (NST) patterns: a randomized prospective controlled study. J Matern Fetal Neonatal Med. 2013; 26 (9): 915-9.
doi: 10.3109/14767058.2013.766698.
- 15. Phelan JP, Kester R, Labudovich ML. Nonstress test and maternal serum glucose determinations. Obstet Gynecol. 1982; 60 (4): 437–9.
- 16. Buscicchio G, Piemontese M, Gentilucci L, et al. The effects of maternal caffeine and chocolate intake on fetal heart rate. J Matern Fetal Neonatal Med. 2012; 25 (5): 528–30.
doi: 10.3109/14767058.2011.636104.
- 17. McShea A, Ramiro-Puig E, Munro SB, et al. Clinical benefit and preservation of flavonols in dark chocolate manufacturing. Nutr Rev. 2008; 66 (11): 630–41.
doi: 10.1111/j.1753-4887.2008.00114.x.
- 18. Hasanpour S, Raouf S, Shamsalizadeh N, et al. Evaluation of the effects of acoustic stimulation and feeding mother stimulation on non-reactive non-stress test: a randomized clinical trial. Arch Gynecol Obstet. 2013; 287 (6): 1105-10.
doi: 10.1007/s00404-012-2695-6.
- 19. Kisilevsky BS, Muir DW, Low JA. Maturation of human fetal responses to vibroacoustic stimulation. Child Dev. 1992; 63 (6): 1497–508.
- 20. Troyano Luque JM, Maeda K, Kurjak A, et al. Fetal extremity kinetics quantified with Doppler ultrasonography. J Perinat Med. 2008; 36 (1): 82-6.
doi: 10.1515/JPM.2008.008.
- 21. U.S. Food and Drug Administration (FDA). Information for manufacturers seeking marketing clearance of diagnostic ultrasound systems and transducers. Rockville, MD: FDA; Sept 30, 1997.
Chocolate Or Fetal Doppler Sonography For Non-Reactive Non-Stress Test Patterns: Randomized Prospective Controlled Study
Yıl 2022,
Cilt: 5 Sayı: 2, 85 - 91, 31.08.2022
Gökhan Karakoç
Serenat Yalçın
,
Hasan Eroglu
,
Halime Şen Selim
,
Kutlu Kurt
Mustafa Şengül
Aykan Yücel
Öz
Aim: The aim of this study is to compare the effect of 20-second MCA Doppler ultrasonography and bitter chocolate on non-stress test (NST) patterns, fetal movements felt by the mother and cesarean delivery rates.
Methods: Single pregnancies between 36-41 weeks with non-reactive NST pattern were included in the study and prospectively randomized to Doppler ultrasound, bitter chocolate, and non-intervention control groups. NSTs of the patients at the 5th and 30th minutes were examined.
Results: The rate of improvement in the fetal movements felt by the mother did not differ significantly among groups (p ˃ 0.05). The 5th minute reactive NST ratio in the Doppler group was significantly higher (p ˂ 0.05) than in the follow-up and chocolate group. In the chocolate and non-intervention control group, the 5th minute reactive NST ratio did not differ significantly (p ˃ 0.05). In the 30th minute NST, patients with non-reactive results had significantly higher fetal distress rates in the Doppler group compared to the other groups (p ˂ 0.05).
Conclusions: We think that with the application of Doppler, the length of hospital stay and accordingly patient’s anxiety will reduce. In addition, the patient should be monitored more carefully in terms of fetal distress because it quickly corrects false non-reactivity.
Kaynakça
- 1. Xi Q, Du J, Liu X, et al. Clinical study on detecting false non-reactive of non-stress test by improved acoustic stimulation. Arch Gynecol Obstet. 2011; 284 (2): 271-4.
doi: 10.1007/s00404-010-1621-z
- 2. Black RS, Campbell S. Cardiotocography versus Doppler. Ultrasound Obstet Gynecol. 1997; 9 (3):148–51.
doi: 10.1046/j.1469-0705.1997.09030148.x.
- 3. Suwanrath C, Suntharasaj T. Sleep-wake cycles in normal fetuses. Arch Gynecol Obstet. 2010; 281 (3): 449–54.
doi: 10.1007/s00404-009-1111-3.
- 4. Paine LL, Strobino DM, Witter FR, et al. Population differences affect nonstress test reactivity. J Perinatol. 1991; 11 (1): 41–5.
- 5. Johnson MJ, Paine LL, Mulder HH, et al. Population differences of fetal biophysical and behavioral characteristics. Am J Obstet Gynecol. 1992; 166 (1): 138–42.
doi: 10.1016/0002-9378(92)91847-4.
- 6. Esin S. Factors that increase reactivity during fetal nonstress testing. Curr Opin Obstet Gynecol. 2014; 26 (2): 61-6.
doi: 10.1097/GCO.0000000000000050.
- 7. Miller FC, Skiba H, Klapholz H. The effect of maternal blood sugar levels on fetal activity. Obstet Gynecol. 1978; 52 (6):662–5.
- 8. Fatemi M, Ogburn PL Jr, Greenleaf JF. Fetal stimulation by pulsed diagnostic ultrasound. J Ultrasound Med. 2001; 20 (8): 883-9.
doi: 10.7863/jum.2001.20.8.883.
- 9. Miller DL, Quddus J. Diagnostic ultrasound activation of contrast agent gas bodies induces capillary rupture in mice. Proc Natl Acad Sci. 2000; 97 (18): 10179-84.
doi: 10.1073/pnas.180294397.
- 10. Nyman M, Barr M, Westgren M. A four-Year follow-up of hearing and develop-ment in children exposed in utero to vibroacoustic stimulation. Br J Obstet Gynaecol. 1992; 99 (8): 685-8.
doi: 10.1111/j.1471-0528.1992.tb13856.x.
- 11. Reeves MJ, Brandreth M, Whitby EH, et al. Neonatal cochlear function: measurement after exposure to acoustic noise during in utero MR imaging. Radiology 2010; 257 (3): 802-9.
doi: 10.1148/radiol.10092366.
- 12. Kafali H, Derbent A, Keskin E, et al. Effect of maternal anxiety and music on fetal movements and fetal heart rate patterns. J Matern Fetal Neonatal Med. 2011; 24 (3): 461-4.
doi: 10.3109/14767058.2010.501122.
- 13. Khooshideh M, Izadi S, Shahriari A, et al. The predictive value of ultrasound assessment of amniotic fluid index, biophysical profile score, nonstress test and foetal movement chart for meconium- stained amniotic fluid in prolonged pregnancies. J Pak Med Assoc. 2009; 59 (7): 471–4.
- 14. Esin S, Baser E, Cakir C, et al. Chocolate or orange juice for non-reactive non-stress test (NST) patterns: a randomized prospective controlled study. J Matern Fetal Neonatal Med. 2013; 26 (9): 915-9.
doi: 10.3109/14767058.2013.766698.
- 15. Phelan JP, Kester R, Labudovich ML. Nonstress test and maternal serum glucose determinations. Obstet Gynecol. 1982; 60 (4): 437–9.
- 16. Buscicchio G, Piemontese M, Gentilucci L, et al. The effects of maternal caffeine and chocolate intake on fetal heart rate. J Matern Fetal Neonatal Med. 2012; 25 (5): 528–30.
doi: 10.3109/14767058.2011.636104.
- 17. McShea A, Ramiro-Puig E, Munro SB, et al. Clinical benefit and preservation of flavonols in dark chocolate manufacturing. Nutr Rev. 2008; 66 (11): 630–41.
doi: 10.1111/j.1753-4887.2008.00114.x.
- 18. Hasanpour S, Raouf S, Shamsalizadeh N, et al. Evaluation of the effects of acoustic stimulation and feeding mother stimulation on non-reactive non-stress test: a randomized clinical trial. Arch Gynecol Obstet. 2013; 287 (6): 1105-10.
doi: 10.1007/s00404-012-2695-6.
- 19. Kisilevsky BS, Muir DW, Low JA. Maturation of human fetal responses to vibroacoustic stimulation. Child Dev. 1992; 63 (6): 1497–508.
- 20. Troyano Luque JM, Maeda K, Kurjak A, et al. Fetal extremity kinetics quantified with Doppler ultrasonography. J Perinat Med. 2008; 36 (1): 82-6.
doi: 10.1515/JPM.2008.008.
- 21. U.S. Food and Drug Administration (FDA). Information for manufacturers seeking marketing clearance of diagnostic ultrasound systems and transducers. Rockville, MD: FDA; Sept 30, 1997.