妊娠高血压综合征患者及胎儿心电图预测胎儿宫内缺氧价值  

Predictive value of fetal electrocardiogram analysis of the pregnant women with pregnancy-induced hypertension for their fetal intrauterine hypoxia

作　　者：邵明容 郑颖 言述 胡世蓉 SHAO Mingrong;ZHENG Ying;YAN Shu;HU Shirong(Guanghan People's Hospital,Guanghan,Sichuan Province,618300)

机构地区：[1]四川省广汉市人民医院,618300

出　　处：《中国计划生育学杂志》2023年第7期1675-1678,1683,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨妊娠高血压综合征(PIH)患者心电图及胎儿心电图(FECG)预测胎儿宫内缺氧价值。方法:回顾性收集2019年1月—2021年1月本院收治的PIH患者137例,根据新生儿出生时1min Apgar评分分为宫内缺氧组与无宫内缺氧组。比较两组孕妇心电图及FECG异常检出率,采用受试者工作特征(ROC)曲线分析PIH患者心电图及FECG对胎儿宫内缺氧的预测价值。结果:137例PIH患者中,发生宫内缺氧24例。宫内缺氧组新生儿1min Apgar评分(6.0±1.0分)低于无宫内缺氧组(9.5±2.0分),窦性心动过缓及ST-T改变发生率高于无宫内缺氧组,孕妇心电图检查总异常率(45.8%)高于无宫内缺氧组(10.6%),FECG检查结果中FST段异常偏移、紊乱型心率失常及心率波动幅度不足发生率均高于无宫内缺氧组,FECG检查总异常率(54.2%)高于无宫内缺氧组(14.2%)(均P<0.05)。ROC分析显示,孕妇心电图检查预测胎儿宫内缺氧的曲线下面积AUC为0.676,FECG检查的AUC为0.700,二者联合预测胎儿宫内缺氧的AUC(0.859)及特异度(83.3%)均高于单一检查(P<0.05)。结论:PIH发生宫内缺氧患者的心电图及FECG异常率较未发生宫内缺氧患者高,孕妇心电图联合FECG检查对PIH患者宫内缺氧发生具有较高的预测价值。Objective:To explore the predictive value of the fetal electrocardiogram(FECG)analysis of the pregnant women with pregnancy-induced hypertension(PIH)for their fetal intrauterine hypoxia.Methods:A total of 137pregnant women with PIH between January 2019and January 2021were collected retrospectively.According to the Apgar scores of the neonates at 1min after born,these women were divided into group A(women with fetal intrauterine hypoxia)and group B(women without fetal intrauterine hypoxia).The abnormal detection rates of the electrocardiogram and FECG of the women were compared between the two groups.The values of the electrocardiogram and the FECG of the women with PIH for predicting their fetal intrauterine hypoxia were analyzed by receiver operating characteristic(ROC)curve.Results:In 137women with PIH,there were 24women with fetal intrauterine hypoxia.The 1min Apgar score(6.0±1.0points)of the neonates in group A was significantly lower than that(9.5±2.0points)of the neonates in group B.The incidences of the sinus bradycardia and the ST-T segment changes in electrocardiography of the neonates in group A were significantly higher than those of the neonates in group B.The total abnormal rate of electrocardiogram(45.8%)of the women in group A was significantly higher than that(10.6%)of the women in group B.The incidences of the abnormal FST segment deviation,the abnormal heart rate,and the insufficient fluctuation amplitude of the fetal heart rate in FECG of the fetuses in group A were significantly higher than those of the fetuses in group B,and the total abnormal rate(54.2%)of the FECG results of the fetuses in group A was significantly higher than that(14.2%)of the fetuses in group B(all P<0.05).ROC analysis showed that the area under the curve(AUC)of the electrocardiogram examination of the pregnant women and the FECG examination for predicting their fetal hypoxia were 0.676and 0.700.The AUC and the specificity of the combined electrocardiogram examination of the pregnant women and the FECG examination for p

关 键 词：妊娠高血压综合征 胎儿宫内缺氧 孕妇心电图 胎儿心电图 预测价值 

分 类 号：R714.5[医药卫生—妇产科学] R714.246[医药卫生—临床医学]