中华耳科学杂志2024，Vol.22Issue(1)：119-124,6.DOI:10.3969/j.issn.1672-2922.2024.01.026
声诱发反应在胎膜早破胎儿听力监测中的应用
A Study on Acoustic Stimulation Test in Monitoring of Fetal Hearing in PROM
陈丽文 1魏日富 1郭丽芳 2刘平 1朱忠寿 1曾笑梅 2林碧芳2
作者信息
- 1. 福建医科大学临床医学部(宁德 352100)||宁德师范学院附属宁德市医院耳鼻咽喉头颈外科
- 2. 福建医科大学临床医学部(宁德 352100)||宁德师范学院附属宁德市医院妇产科
- 折叠
摘要
Abstract
Objective To investigate the feasibility of fetal hearing monitoring in prelabor rupture of membranes(PROM)using acoustic stimulation test.Methods Pregnant women with PROM admitted to the Department of Obstet-rics and Gynecology,Ningde Hospital affiliated to Ningde Normal University from June 2018 to December 2021(n= 2725)were divided into a reproductive tract infection(RTI)group(n=918)and a non-RTI group(n=1807)based on their vaginal secretion pathogen test results at the time of PROM.By gestational age,1792 cases were full-term(pregnancy≥37 weeks)and 933 cases were premature(pregnancy≤28 weeks<37 weeks).Non-PROM newborns(n=600)were used as control.All PROM subjects received AST followed by neonatal hearing screening and diagnostic testing as indicated.Results were compared among the groups.Results The rate of positive AST was lower in premature and full-term RTI newborns than that in non-RTI newborns and controls(P<0.05).At 3 months,acoustic impedance and DPOAE findings were similar between full-term and preterm PROM infants and controls(P>0.05),although their ABR wave V thresh-olds were higher than those in non-PROM infants.At 6 months,acoustic impedance,DPOAEs and wave V thresholds were all similar among PROM and non-PROM infants,full-term or preterm(P>0.05).Among infants with confirmed hearing loss,more than half initially had abnormal acoustic impedance,low DPOAE pass rate and elevated wave V thresholds,although all of these indices improved along with age in all groups excluding full-term PROM infants.Hear-ing loss was generally mild or moderate in those with positive AST,but tended to be moderate or severe or involving both ears in those with negative AST.The area under curve(AUC)for AST in detecting fetal hearing loss was 0.821,and 0.915 when combined with DPOAEs,especially for severe and profound hearing loss.Conclusion AST can be used to detect and predict fetal hearing loss in PROM in selected cases,especially when confounded with RTI,where negative AST is associated with increased probability of hearing loss.Negative AST in PROM indicates the need hearing moni-toring and follow-ups.关键词
声诱发反应/胎膜早破/听力损失Key words
acoustic stimulation test/prelabor rupture of membranes/hearing loss引用本文复制引用
陈丽文,魏日富,郭丽芳,刘平,朱忠寿,曾笑梅,林碧芳..声诱发反应在胎膜早破胎儿听力监测中的应用[J].中华耳科学杂志,2024,22(1):119-124,6.
