居家孕妇远程胎心监护103例临床分析  

Clinical Analysis of 103 Cases of Pregnant Women with Remote Fetal Monitoring at Home

作　　者：张珂[1] 韩秀君[1] 贺晶[1] 李文娟[1] 杨旋[1] 周庆利 ZHANG Ke;HAN Xiujun;HE Jing(Department of Obstetrics,Women＇ sHospital,School of Medicine,Zhejiang University,Hangzhou Zhejiang 310006,China)

机构地区：[1]浙江大学医学院附属妇产科医院,浙江杭州310006 [2]浙江大学医学院附属第四医院,浙江义乌322000

出　　处：《实用妇产科杂志》2018年第8期629-632,共4页Journal of Practical Obstetrics and Gynecology

基　　金：浙江省科技厅公益技术研究社会发展项目(编号:2014C33082)

摘　　要：目的:探讨居家孕妇远程胎心监护的临床实践及其应用价值。方法:选择2015年12月至2017年2月在浙江大学医学院附属妇产科医院产前检查的晚期妊娠103例孕妇,其中正常妊娠孕妇50例为正常组,具有高危因素及妊娠合并症或并发症的孕妇53例为高危组。两组孕妇在家进行远程胎心监护,由专业医师对启用孕周、归还/分娩孕周、使用时间、远程胎心监护上传时间和次数(分成≤3次、4~9次及≥10次)等进行分析,同时追踪监护结果及分娩结局。结果:(1)两组孕妇启用孕周比较差异无统计学意义(P>0.05),高危组孕妇远程胎心监护的归还/分娩孕周及使用时间均短于正常组(P<0.05)。(2)103例孕妇共上传654次,其中≤3次、4~9次及≥10次孕妇的比较中,文化程度(大专及以上)、启用孕周和使用时间上差异有统计学意义(P<0.05),而年龄、产次、高危人数及归还/分娩孕周的比较,差异无统计学意义(P>0.05)。(3)高危组胎心监护结果异常率(22.8%)高于正常组(5.1%),差异有统计学意义(P<0.05)。而两组异常结果复查的比较,差异无统计学意义(14.3%vs 16.2%,P>0.05)。(4)远程胎心监护结果异常孕妇中的脐带因素、胎儿窘迫、新生儿窒息、新生儿并发症入NICU的发生率明显高于结果正常孕妇(P<0.05)。结论:孕妇远程胎心监护开启了家庭自我监护新途径,是胎儿安全的有力保障,尤其适合于高危妊娠;对伴有脐带因素的胎儿孕期管理具有很好的监测作用。Objective： To explore the clinical practice and application value of remote monitoring of pregnant women at home.Methods： 103 pregnant women who took the antenatal examinationin women＇shospital,school of medicine,Zhejiang University from December 2015 and February 2015 were enrolled in the study. All the cases were divided into two groups,50 cases of pregnant women with normal pregnancy as the normal group,53 cases with the high risk factors and pregnancy complications as high-risk group. Two groups of pregnant women both had remote fetal monitoring at home,The start,return of the monitoring system,delivery gestational age,use time,remote monitoring the upload time and times（ ≤3 times,4-9 times and ≥10 times） were analyzed by medical professional,at the same time the monitoring results and birth outcomes were tracked.Results：（1）There was no statistically significant difference on the start gestational week between the two groups（ P〈0. 05）,and the return/delivery time and using time of the pregnant women in the high-risk group was shorter than those in the normal group（ P〈0. 05）.（2）103 cases of pregnant women uploaded 654 times,among the ≤3 times,4-9 times and ≥10 times groups,there were differences on the level of education（ junior college or above）,start gestational age and using time,and the difference was statistically significant（ P〈0. 05）,while there was no statistically significant difference on the age,number of production time,high risk and return/delivery gestational age（ P〈0. 05）.（3）The abnormal rate（ 22. 8%） in high-risk group was higher than that in the normal group（ 5. 1%）,and the difference was statistically significant（ P〈0. 05）. There was no difference on the reexaminations results（ 14. 3% vs 16. 2%,P〈0. 05）.（4） The incidence of umbilical cord factor,fetal distress,neonatal asphyxia and neonatal complications in the high-risk group was significantly higher than that in the normal group（ P〈0. 05）.Conclusions�

关 键 词：居家 远程 胎心监护 高危妊娠 围产儿预后 

分 类 号：R715.7[医药卫生—妇产科学]