胎心率基线变异对分娩方式选择及围产儿结局的影响  

Influences of baseline variability of fetal heart rate on the delivery mode and perinatal outcomes

作　　者：孙宇[1] 杨奕梅 张静[1] 杨丽娟 王爱华[1] 沈翠花[1] SUN YU;YANG Yimei;ZHANG Jing;YANG Lijuan;WANG Aihua;SHEN Cuihua(Kunming Maternal and Child Health Care Hospital,Yunnan Province,650011)

机构地区：[1]云南省昆明市妇幼保健院,650011

出　　处：《中国计划生育学杂志》2022年第2期474-477,共4页Chinese Journal of Family Planning

摘　　要：目的:探讨胎心率基线(BFHR)变异对分娩方式及围产儿结局的影响。方法:回顾性分析2018年10月-2020年1月本院产科诊治的100例BFHR变异减弱孕产妇(观察组)以及100例BFHR变异正常孕产妇(对照组)临床资料,比较两组电子胎心监护结果、NST类型、羊水过少发生情况,追踪妊娠结局比较分娩方式及围产儿结局。结果:观察组NST正常67例(67.0%),不典型20例(20.0%),异常13例(13.0%),与对照组(87.0%、13.0%、0%)有差异(P<0.05)。观察组羊水污染、羊水过少、胎盘早剥、帆状胎盘、球拍状胎盘发生率均高于对照组(10.0%比0.0%、15.0%比2.0%、17.0%比2.0%、10.0%比0%、18.0%比3.0%),剖宫产率、死胎、宫内窒息、小于胎龄儿发生率分别高于对照组(70.0%比48.0%、10.0%比0%、15.00%比2.0%、16.0%比0%),新生儿pH<7.2、Apgar评分<7分发生率高于对照组(13.0%比0%、36.0%比8.0%)(均P<0.05)。logistic分析BFHR变异减弱是围产儿不良结局的独立危险因素(β=2.134,P=0.000)。结论:BFHR变异减弱提示胎儿宫内窘迫的可能,围产儿不良结局风险较大,应加强对胎心率基线变异或减弱孕妇的观察。Objective: To investigate the influence of baseline variability of fetal heart rate(BFHR) on the delivery mode and perinatal outcomes. Methods: The clinical data of 100 pregnant women with weaken of BFHR(in observation group) and 100 pregnant women with normal BFHR(in control group) from October 2018 to January 2020 were retrospectively analyzed. The results of electronic fetal heart rate monitoring, the NST type, and the oligohydramnios rate were compared between the two groups. These women were followed up to the end of pregnancy, and the delivery mode and the perinatal outcomes were compared between the two groups. Results: There were 67(67.0%) women with normal NST, 20(20.0%) women with atypical NST, and 13(13.0%) women with abnormal NST in the observation group, which had significant different from those(87.0%, 13.0%, and 0%) of the women in the control group(P<0.05). The incidences of amniotic fluid contamination, oligohydramnios, placental abruption, vela placenta, and racquet placenta of the women in the observation group were 10.0%, 15.0%, 17.0%, 10.0%, and 18.0%, repectively, which were significantly higher than those(0.0%, 2.0%, 2.0%, 0%, and 3.0%, repectively) of the women in the control group. The rates of cesarean section, stillbirth, intrauterine asphyxia, and small gestational age in the observation group were 70.0%, 10.0%, 15.00%, and 16.0%, repectively, which were significantly higher than those(48.0%, 0%, 2.0%, and 0%, repectively) in the control group. The percantages of neonatal blood gas analysis result of pH <7.2 and neonatal Apgar score <7 in the observation group were 13.0% and 36.0%, which were significantly higher than those(0% and 8.0%) in the control group. Logistic analysis showed that the weakened of BFHR was an independent risk factor of adverse perinatal outcomes(β=2.134, P=0.000). Conclusion: The weakened BFHR indicates the possibility of fetal distress in uterus and the higher risk of adverse perinatal outcomes, so the pregnant women with weakened BFHR should be focused on.

关 键 词：胎心率基线变异 分娩方式 围产儿结局 胎儿宫内窘迫 新生儿 

分 类 号：R714[医药卫生—妇产科学]