电子胎心监护诊断胎儿窘迫的临床观察

The Clinical Observation of Electronic Fetal Heart Rate Monitoring in Diagnosing Fetal Distress

目的探讨电子胎心监护与胎儿窘迫及剖宫产率之间的关系。方法回顾分析4674例住院分娩孕妇的胎心电子监护图形。结果发现胎心监护图形异常者382例,其中223例考虑胎儿窘迫行剖宫产术,术中发现异常因素者175例,未发现异常因素者48例。胎心基线变异明显减弱或消失、重度变异减速、延长减速及晚期减速者发生羊水粪染、脐带缠绕及新生儿窒息比例明显高于其它胎心监护图形异常者。结论电子胎心监护能早期发现胎儿窘迫,但是,单凭胎心监护图形异常作为胎儿窘迫诊断会出现假阳性判断,当出现异常图型时,应严密监护,根据胎心率异常的程度及胎儿能够娩出的时间选择恰当的分娩方式,可减少围产儿病死率。

Objective Probing the relationship between electronic fetal heart rate monitoring,fetal distress and the rate of cesarean section.Methods Reviewing the patterns of the electronic fetal heart rate monitoring of 4674 giving birth women in our hospital.Results We found 382 abnormal cases of them,considering of fetal distress 223 pregnant women were given cesarean section.During operation 175 cases were found to be abnormal,the others were normal.FHR-baseline obviously reducing or disappearing,VD,PD and LD could lead to meconium-stained amniotic fluid,cord entanglement and neonatal asphyxia,it was obviously higher than the others abnormal patterns.Conclusion Electronic fetal heart rate monitoring could find fetal distress in time,but if we diagnose fetal distress only rely on the electronic fetal heart rate monitoring,we would draw a false positive judgment,when the abnormal patterns appear,we should take a close observation,according to the abnormal degree and the given laboring time we could choose a correct laboring method to reduce the death rate of newborn.