第二产程异常胎心监护图形与新生儿结局的关系  

Relationship between abnormal fetal heart rate tracing patterns during the second steage of labor and perinatal outcome

作　　者：何艳君[1] 黄文宇[1] 王莹[1] 黄海红[1] 

机构地区：[1]中山市博爱医院产科,广东中山528403

出　　处：《中国基层医药》2005年第7期841-843,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨第二产程异常胎心监护图形与新生儿结局的关系。方法回顾性分析我院足月单胎头位分娩产妇第二产程中胎心率(FHR)正常者264例(对照组)和胎心率异常者298例(观察组)的资料。结果FHR异常的发生率为53%,异常胎心率类型包括轻度变异减速(56·0%),其次为早期减速(19·5%)和晚期减速(11·4%)。其他异常FHR为:心动过速、心动过缓、基线变异减弱,重度变异减速和延长减速。观察组羊水粪染10·4%、新生儿窒息4·4%,对照组羊水粪染6·8%、新生儿窒息2·3%,组间差异无显著意义(P>0·05)。结论第二产程中FHR异常发生率高,多由于产程中胎头受压或脐带受压而引起的迷走神经反射或暂时性子宫胎盘血流减少引起,并非缺氧所致,不必急于干预。Objective We investigated the correlations between abnormal fetal rate（FHR） during the second stage of labor and fetal outcome. Methods The data of 562 nulliparas with single vertex in the second stage of labor（264 eases with normal FHR,298 cases with abnormal FHR） were analyzed retrospectively. Results The incidence of abnormal FHR in the second stage of labor was 53 %. The patterns of abnormal FHR included ： 167 （56.0%） eases with mild varible deceleration（VD） ;58（19.5%） cases with early deceleration（ED） ;34（11.4%） cases with late deceleration（LD） ; The other abnormal FHR included tachyeardia, bradyeardia, reduced baseline variability ,severe variability decelerations and prolonged deceleration（PD）. There was no difference of meconium-stained amniotic fluid and newborns with low Apgar score between two groups. Conclusions There was a very high incidence of abnormal FHR during the second stage of labor,however, the most cases were response to parasympathetic stimulation due to umgilieal cord or fetal head compression by mothers over push and descent of fetal head,or temporal diminishing of uterine placenta blood flow. It suggests that it is unnecessary to intervene immediately.

关 键 词：第二产程异常 胎心监护图形 新生儿 妊娠结局 

分 类 号：R714.7[医药卫生—妇产科学]