Does cardiotocography have a role in the antenatal management of pregnancy complicated by gestational diabetes mellitus?

作者：Jeffery Timothy; Petersen Rodney; Quinlivan Julie^*

来源：Australian & New Zealand Journal of Obstetrics & Gynaecology, 2016, 56(4): 358-363.

DOI：10.1111/ajo.12487

• cardiotocography
• cohort study
• gestational diabetes mellitus
• number needed to treat
• pregnancy

BackgroundControversy surrounds the role of fetal cardiotocography (CTG) in the antenatal management of pregnancy complicated with gestational diabetes mellitus (GDM).
AimThe aim was to investigate whether antenatal CTG aids management in pregnancy complicated by GDM.
Materials and methodsA prospective audit of 1404 consecutive antenatal CTG in women diagnosed with GDM. Outcomes for all CTG were audited to determine whether CTG altered pregnancy management.
ResultsIn women requiring combination therapy (diet and medication), 43 CTG were required to change management of a pregnancy. In women managed by dietalone with a secondary pregnancy complication, 161 CTG were required to change management. In women managed by dietalone with no secondary pregnancy complication, CTG did not change management.
ConclusionsAntenatal CTG is not recommended in women with GDM managed by dietalone with no secondary pregnancy complication. Antenatal CTG is recommended in women with GDM who require combination therapy (diet and medication). The role of CTG in women managed by dietalone with a secondary pregnancy complication should be based upon the nature of the complication.

• 出版日期2016-8