产前无应激试验低评分的相关因素及围产结局  

The related factors and perinatal outcomes of the low scores about prenatal nonstress test

作　　者：彭可[1] 

机构地区：[1]广东省惠州市中心人民医院妇产科,516001

出　　处：《中国实用医药》2008年第30期19-20,共2页China Practical Medicine

摘　　要：目的探讨无应激试验低评分的相关因素及临床意义,寻求最佳分娩方式。方法用电子胎儿监护仪对1431例孕妇进行无应激试验(NST),对其中129例NST≤9分者按正常妊娠和高危妊娠分两组进行分析。结果高危妊娠组胎心基线率变异消失或减弱为74.3%,剖宫产率占91.4%,羊水粪染率占71.4%,新生儿窒息率占28.6%,有2例围产儿死亡;正常妊娠组相对应数据分别为24.5%、55.3%、19.1%、2.1%,无围产儿死亡病例。两组比较差异有显著性(P<0.01)。分析两组相关因素,高危妊娠组中羊水过少,妊娠期肝内胆汁淤积症、妊娠期高血压疾病及胎儿生长受限等病症占有一定比例;而正常妊娠组产后发现明显原因致NST低评分系脐带因素的有28例(29.8%),无明显原因者占67.0%。结论高危妊娠NST低评分者应引起高度重视,适时终止妊娠,降低围产儿病死率;正常妊娠NST低评分者可行OCT、生物物理评分等进一步监测,选择适当分娩方式。Objective To study related factors and clinical meaning of the low scores about nonstress test,and find out the best childbearing mode. Methods 1431 cases of pregnant women were tested with non- stress test（NST）. 129 cases with NST≤9 scores in 1431 eases were divided into two groups between normal pregnaney group and high risk pregnaney group. Results Rate of reduetion or disappearance of baseline variability in high risk pregnancy group was 74. 3 %, eaesearean seetion was 91.4%, meconium stained amniotie fluid was 71.4% ,and asphyxia neonatornm was 28. 6% and there were 2 perinatal newborns dead; But the date of normal pregnancy group was 24. 5% ,55.3%, 19. 1%, and 2. 1% respeetively. There were no perinatal newborns dead in this group（ P 〈 0. 01 ）. Analyzing related factors, oligohydramnios, ICP, HDCP and FGR were major ones in high risk pregnancy group. In contrast, umbilieal factors which gave rise to low scores after parturition in the normal pregnancy group were 28 eases （29. 8% ）while no obvious factors were 67. 0%. Conclusion More attention should be paid to high risk pregnancies which were low scores, and pregnancy should be terminated promptly in order to lower perinatal mortality ;The pregnant women in normal pregnancies should be tested with OCT, BPS and so on. It should choose appropriate childbearing method to further monitor.

关 键 词：胎儿监测 产前诊断 妊娠 高危 分娩 

分 类 号：R714.7[医药卫生—妇产科学]