产前胎儿监护预测不良妊娠结果的探讨  

Appraisal of antenatal surveillance in predicting unfavorable results in pregnancy

作　　者：苏 林其德[1] 刘芳荪[1] 楼薇华 

机构地区：[1]上海第二医科大学仁济医院妇产科

出　　处：《上海医学》1998年第9期500-502,共3页Shanghai Medical Journal

摘　　要：目的：采用尿Ｅ３、生物物理相评分、脐动脉血流对胎儿进行产前监护，预测胎儿宫内健康状况，降低围产期胎儿死亡率和患病率。方法：采用３种方法（尿Ｅ３、生物物理相评分、脐动脉血流）对选择性剖宫产术前之孕妇进行监测。结果：阳性结果与胎儿窘迫关系均高于阴性组发生率（Ｐ＜００１）。在假阴性方面脐动脉血流方法明显低于尿Ｅ３方法和生物物理相评分方法（Ｐ＜００１，Ｐ＜００１）。阳性结果与新生儿窒息的关系３种方法明显高于同种方法的阴性组发生率（Ｐ＜００１，Ｐ＜００５，Ｐ＜００５），在假阳性尿Ｅ３方法和生物物理相评分方法有明显差异（Ｐ＜００１）。阳性结果与胎儿宫内生长迟缓（ＩＵＧＲ）的关系为尿Ｅ３及脐动脉血流阳性方法明显高于阴性组（Ｐ＜００１，Ｐ＜００５），在假阳性方面，尿Ｅ３方法与生物物理相评分方法有显著性差异（Ｐ＜００１）。结论：３种方法各有优点，在观察中应该根据不同的条件及孕妇来采用，最好要多种检查。Objectives: To investigate the value of determination of urine E3.biophysical estimation and umbilical arterial blood in pregnant women.Methods:The results of urine E3,biophysical estimation and umbilical arterial blood were analyzed retrospectively in 1195 pregnant women. Results:The rate of fetal distress increased significantly in the positive group as compared with the negative group(P<001).The false negative rate decreased significantly in umbilical arterial blood group as compared with urine E3 group and biophysical estimation groups. The rate of infant asphyxia increased significantly in the positive group by these methods as compared with the negative groups (P<001,P<005,P<005).The false positive rate decreased significantly in the urine E3 group as compared with the biophysical estimation groups. The complication of IUGR increased significantly in the positive urine E3 and umbilical arterial blood group (P<0.01,P<0.05).Obvious difference was found in the false positive urine E3 group and the biophysical estimation groups (P<0.01).Conclusion:All three methods had their advantages. During clinical practice, the method used should be individualized according to the clinical condition and the status of the pregnant women.Multiple examinations for should be performed. prevention and treatment of early complications.

关 键 词：妊娠 尿E3 脐动脉血流 胎儿 产前监护 

分 类 号：R714.5[医药卫生—妇产科学]