远程胎监对羊水过少孕妇监测的临床应用

The Clinical Application of Long Distance Fetal Heart Rate Monitoring in the Pregnant Women with Oligohydramnios

目的:研究羊水过少孕妇行远程胎儿监护、住院监护及自数胎动的监测效果。方法:根据监护系统不同,将269例羊水过少孕妇分为远程监护组(A组)、住院监护组(B组)和自数胎动组(C组),分别比较3组无应激试验(NST)结果,比较剖宫产率、围生儿结局(胎儿窘迫、羊水Ⅲ度污染、新生儿窒息率)的资料。结果:C组NST反应型、无反应型发生率显著高于A、B两组(P<0.05),A、B两组的差异无显著性(P>0.05)。C组胎儿窘迫、羊水Ⅲ度污染率、新生儿窒息率显著高于A、B两组(P<0.05)。A组剖宫产率(51.0%)显著低于B组(55.1%)和C组(65.3%)(P<0.05)。结论:远程胎儿监护与住院监护同样有效,能减少过早干预,为羊水过少孕妇家庭自我监护提供了一条可行途径。

Objective：To study the monitoring results of long distance fetal heart rate（FHR） monitoring, being in hospital FHR monitoring, and family self-numerating fetal movement in the pregnant women with oligohydramnios. Methods：To divide the 269 pregnant women with oligohydramnios from 2003 to 2006 in our hospital into three groups： long distance FHR monitoring group（A group）, being in hospital FHR monitoring group （B group） ,and family self- numorating fetal movement group（C group）. Non- stress test（ NST, NST divided into reactive pattern, non reactive pattern, combined pattern and abiogenesis drag acceleration）, uterine- incision delivery rate,and perinatal outcome （fetal distress, amniotic fluid Ⅲ0 stained and neonate apnoea rate） were analyzed compered among them.Results：The incidence of non - reactive pattern in group C was significantly higher than group A and group B （ P 〈 0.05）, but there was no difference between the latter two groups （ P 〉 0.05）. The rate of uterine - incision delivery in group A （51.0%） was significantly lower than group B （53.9%） and group C （65.3%） （ P〈 0.05） . The incidences of fetal distress, amniotic fluid Ⅲ° stained,and apnoea neonatorurn in group C were signifi- cantly higher than group A and group B （P〈0.05） .Conclusions：The long distance FHR monitoring is as effective as being in hospital FHR monitoring,can reducing the cost of hospitalization,avoid earlier intervention ,and provide a feasibile pathway for pregnat women with oligohydramuios.