临产前后胎心率监护预测产时胎儿情况的调查

Monitoring Fetus Heart Rate before and after Labor in Estimation of Fetus Status during Delivery

目的对孕妇临产前后行胎心率监护，预测胎儿在宫内的储备能力，以降低胎儿或新生儿的病死率。方珐对孕龄在37～41周的750例住院孕妇临产前后进行常规的胎心率监护，包括无应激试验（non-stress test，NST）、宫缩应激试验（contraction stresstest，CST）和缩宫素应激试验（oxytocin challenge test,OCT）试验，并分析胎心监护与胎儿脐带绕颈、新生儿窒息和胎儿生长受限之间的关系。结果胎心率监护750例中，出现频繁的变异减速与胎儿脐带绕颈关系显著；胎心率评分与新生儿窒息及胎儿生长受限关系显著（P〈0．01）。结论临产前后行NST、CST或OCT试验，可预测产时胎儿在宫内的储备能力并及时发现胎儿宫内缺氧等不良反应，从而尽快改善围产儿的预后。

Objective To estimate the fetus reserve ability in uterus by monitoring fetus heart rate before and after labor, so as to lower the rate of fetus or.neonatal death. Methods The conventional fetal heart rate monitoring was conducted before and after labor in 750 hospitalized pregnant women with gestational ages from 37 weeks to 41 weeks. The Fischer assessment,the non-stress test （NST）, contraction stress test （CST） and oxytocin challenge test （OCT） were also performed. The relationship between heart rate monitoring with umbilical cord around the neck,neonatal asphyxia,and restriction of neonatal growth was also analyzed. Results In the 750 cases of fetal heart rate monitoring,frequent variable deceleration had a notable relationship with incidence of umbilical cord surrounding the neck. The fetal heart rate had a notable relationship with fetus asphyxia and fetal growth restriction （ P 〈 0. 01）. Conclusion Fetal heart rate supervision of NCT,CST and OCT can estimate the fetus reserve ability in uterus and discover the fetal distress in uterus, so as to improve the perinatal prognosis of the newborns.