妊娠图筛查在产前胎儿生长受限诊断中的应用  

Application of pregnogram screening in prenatal diagnosis of fetal growth restriction

作　　者：安丽琴 马静 卢艳娜 

机构地区：[1]昌黎县人民医院产科,河北昌黎066600 [2]昌黎县妇幼保健院产科,河北昌黎066600

出　　处：《中国妇幼保健》2016年第14期2878-2880,共3页Maternal and Child Health Care of China

基　　金：2014秦皇岛科学技术研究和发展计划项目(201401A151)

摘　　要：目的探讨妊娠图筛查在产前胎儿生长受限诊断中的应用。方法选择2012年1月-2015年5月进行常规产前检查的单胎孕妇12 853例,采用昌黎县新绘制的正常孕妇妊娠图作为标准进行产前筛查,对可疑的产妇行B超检查确诊。对确胎儿生长受限患者给予相应治疗,选择同期生产的300例正常胎儿为对照组,观察FGR治愈组、无效组胎儿窘迫、新生儿1 min Apgar评分、胎龄、出生体重、分娩方式等发生情况。结果 12 853例孕妇中,通过妊娠图筛查出188例疑似胎儿生长受限患者,经B超确诊为胎儿生长受限的有164例,胎儿生长受限孕妇宫高、腹围、体重增长缓慢,与正常妊娠图比较低于其10%下限。无效组发生胎儿窘迫、剖宫产率及新生儿1 min Apgar评分≤7的发生率均高于对照组(P<0.05),胎龄和出生体重均低于对照组(P<0.05),治愈组胎儿各指标与对照组相比差异无统计学意义(P>0.05)。结论妊娠图筛查胎儿生长受限显著有效,应加强孕期产前检查,重视妊娠图的使用,有利于防治胎儿生长受限和改善预后,值得临床推广应用。Objective To explore the application of pregnogram screening in prenatal diagnosis of fetal growth restriction（ FGR）.Methods A total of 12 853 singleton pregnant women receiving routine prenatal examination from January 2012 to May 2015 were selected.The pregnogram of normal pregnant women newly drawn by Changli county was used as a standard for prenatal screening,the suspected pregnant women were diagnosed definitely by ultrasonography.The patients with FGR were treated correspondingly.A total of 300 normal fetuses who were born during the same period were selected as control group.The incidence rates of fetal distress,neonatal one-minute Apgar scores,fetal age,birth weights,delivery modes in FGR cure group and FGR ineffective group were observed.Results Among 12 853 pregnant women,188 pregnant women suspected of FGR were screened out by pregnogram,and 164 pregnant women were diagnosed definitely by ultrasonography.Fundal height,abdominal circumference,and weight increased slowly among the pregnant women with FGR,which were lower than 10% lower limit of normal pregnogram.The incidence rates of fetal distress,cesarean section,and neonatal one-minute Apgar score≤7 in FGR ineffective group were statistically significantly higher than those in control group（ P 〈 0.05）,fetal age and birth weight were statistically significantly lower than those in control group（ P〈0.05）.There was no statistically significant difference in various indexes between FGR cure group and control group（ P〉 0.05）.Conclusion Pregnogram screening used for FGR is effective,strengthening progestational and prenatal examination and paying attention to pregnogram are helpful to prevention and treatment of FGR and improvement of prognosis,which is worthy of clinical promotion and application.

关 键 词：昌黎县 妊娠图 胎儿生长受限 新生儿Apgar评分 

分 类 号：R714.51[医药卫生—妇产科学]