产程中电子胎心监护对胎儿窘迫的诊断价值  

The value of fetal heart rate monitoring in labor for diagnosing fetal distress

作　　者：陈红波[1] 汪胜友[1] 叶俊良[1] 

机构地区：[1]安徽医科大学妇幼保健临床学院,安徽省合肥市妇幼保健院妇产科,230001

出　　处：《蚌埠医学院学报》2013年第11期1433-1435,共3页Journal of Bengbu Medical College

摘　　要：目的:探讨持续电子胎心监护(EFM)在分娩过程中的应用价值。方法:选择1 298例单胎足月孕妇作为观察组,在分娩过程中应用中央监护站系统进行持续EFM;同时选取既往产程中未行持续EFM的862例孕妇作为对照组。分别计算2组的羊水粪染率、以胎儿窘迫为指征的剖宫产率及产钳助产率、新生儿窒息率,并检测EFM异常孕妇分娩后新生儿脐动脉血pH值。结果:观察组以胎儿窘迫为指征的剖宫产率为21.4%,高于对照组的15.0%(P<0.01);观察组新生儿窒息率及重度窒息率分别为4.5%和1.4%,低于对照组的7.2%和2.7%(P<0.01和P<0.05)。2组胎儿窘迫诊断率、羊水粪染率、以胎儿窘迫为指征的产钳助产率差异均无统计学意义(P>0.05);观察组第二产程胎儿窘迫率10.7%,低于对照组的14.0%(P<0.05)。观察组中EFM异常图形病例脐动脉血pH值为7.25±0.26,低于EFM正常图形病例的7.34±0.18(P<0.01)。结论:采用中央监护站系统在产程中进行持续EFM,可以早期发现胎儿窘迫,为早期处理和干预提供依据。Objective：To explore the value of continuous fetal heart rate monitoring in labor for diagnosing fetal distress. Methods： One thousand two hundred and ninety-eight full-term pregnant women with single fetus and 862 pregnant women without continuous fetal heart rate monitoring in labor were set as the observation and control group, respectively. The fetal heart rate of the observation group was continuously monitored using central type monitor system in labor. The amniotic fluid turbidity rate, cesarean section rate with the indication of fetal distress, forceps delivery rate and neonatal asphyxia rate of two groups were calculated. The pH value of umbilical artery blood of neonates with abnormal fetal heart rate were measured. Results： The cesarean section rate with the indication of fetal distress of observation group was 21.4% ,which was significantly higher than that of control group（ 15.0% ） （ P 〈 0.01 ）. The neonatal asphyxia rate and the severe asphyxia rate of observation group were 4.5% and 1.4% , which were significantly lower than those of control group（7.2% and 2.7% ）（ P 〈 0.01 and P 〈 0.05 ）. The fetal distress, amnioti＇c fluid turbidity and forceps delivery with the indication of fetal distress rates of two groups had no significant differenee（P 〉0.05）. The fetal distress rate of observation group was 10.7% on the second stage of labor, which was lower than that of control group （ 14.0% ） （ P 〈 0.05 ）. The pH value of umbilical artery blood of neonate with abnormal fetal heart rate pattern was 7.25± 0.26 ,which was significantly lower than that of neonate with normal fetal heart rate pttern 7.34 ± 0. 18 （P 〈 0.01 ）. Conclusions： The continuous fetal heart rate monitoring using central type monitor system can early diagnose the fetal distress, which can provide the basis of early treatment and intervention.

关 键 词：电子胎心监护 胎儿窘迫 新生儿窒息 血气分析 

分 类 号：R714.7[医药卫生—妇产科学]