入室试验筛查分娩中胎儿宫内窘迫的意义

Application of admission test to screen fetal distress in labor

目的：探讨胎心入室试验对预测新生儿宫内窘迫的价值。方法：将2000年1月-2005年1月入我院后24h内分娩的658例孕妇（33^＋5～43孕周）分为低风险组和高风险组，分析其胎心入室试验、分娩结局、羊水及新生儿Apgar评分。结果：AT示515例为反应型（78．27％），72例为可疑型（10．94％），71例为危险型（10．79％）；总的新生儿窒息率为6．53％，反应型组窒息率为1．94％，危险组为33．08％；羊水污染率反应型组为20．97％，危险组为67．61％，两组间差异显著（P〈0．01）。高危孕妇司疑型、危险型的羊水污染率及新生儿窒息率均较低风险孕妇高，两组间有显著差异（P〈0．05）。结论：AT反应型可预测在以后的4～5h内胎儿在宫内是安全的，胎心入室试验可预测胎儿预后。

Objective： To evaluate the value of admission test of fetal heart rate in predicting fetal distress in labor. Methods： 658 pregnant women who had been pregnant for 33＋5 to 43 weeks and planed to labor spontaneously were divided into low risk group（n=598） and high - risk group （n=60）. The admission test of fetal heart rate was applied to monitor the fetal distress in labor and the results were compared with result of delivery, condition of amniotic fluid contamination and Apgar scores of newborns. Results：515 cases was reactive type（78. 72%）, 72 ones was equivocal type（10. 94%） and 71 ones was ominous type（10. 79%）. Total incidences of neonatal asphyxia were 6. 53%, and it was 1.94%, 12. 50% and 33. 80% in reactive type subjects, equivocal type subjects and ominous type subjects, respectively. The rates of amniotic fluid contamination were 20. 97%, 48. 61% and 67. 61 in reactive type subjects, equivocal type subjects and cminous type subjects, respectively. The incidences of amniotie fluid contamination and neonatal asphyxia were Lower significantly in the low risk group than those in the high - risk group（P 〈0. 05）. Conclusion：Admission test of fetal heart rate is a good method and be used to screen fetal distress in labor.