胎心无负荷试验和脑、脐动脉血流超声监测宫内窘迫胎儿预后

Study on Fetal Prognosis by Applying Non-stress Test,Blood Flow Testing of Cerebral and Umbilical Arteries

目的探讨联合应用胎心无负荷试验(NST)和脑、脐动脉血流监测对预测胎儿预后的临床价值。方法对孕37～42周孕妇用胎心监护仪监护,无反应型者再用彩超检测脐动脉血流速度(S/D)值及大脑中动脉血流速度(S/D)值,并对胎儿宫内窘迫者的NST、S/D值、新生儿脐血血气分析和新生儿Apgar评分进行比较分析。结果胎心监护、脐血流与大脑中动脉血流检测均不同程度地存在一定缺陷,各项监测指标均正常者表示胎儿宫内情况良好,各项监测指标均异常者提示胎儿宫内情况危急,需引起高度重视,应采取积极的措施。结论胎心监护、脐血流与大脑中动脉血流检测联合应用可弥补单纯胎心监护、脐血流、大脑中动脉血流检测诊断胎儿宫内窘迫的不足,产后正确诊断新生儿窒息,降低假阳性率及盲目剖宫产率,正确预测胎儿宫内安危及胎儿预后的可靠性。

Objective To explore the clinical significance of predicting fetal prognosis by using nonstress text（NST） ,blood flow testing of cerebral and umbilical arteries. Methods Fetal heart monitor apparatus is applied to monitor the pregnant women with gestation from 37 to 42 weeks. As to those who have no reaction, color ultrasound is used to test the blood flow speed （ S/D ） values of umbilical artery and cerebral medium sized artery, and NST and S/D values of those who have fetal distress, blood gas analysis on umbilical blood of neonate and neonatal apgar scoring are compared and analyzed. Results There exist some defects to different extents in the fetal heart monitoring and testing of the blood flow of umbilical artery and cerebral medium sized artery. If all the monitoring indexes are normal,it means that the intrauterine fetal condition is good, while anomalies in all of the monitoring indexes suggest the emergency of intrauterine fetal condition, and great attention should be paid, some effective measures taken accordingly. Conclusion The combined application of fetal heart monitoring, blood flow testing of umbilical artery and cerebral medium sized artery can remedy the defect of simply using one of them to diagnose fetal distress. And there is great significance for correctly diagnosing postpartum neonatal asphyxia after delivery ,lowering the rate of false positivity and that of blind cesarean section ,correctly predicting fetal safety in uterus and enhancing the reliability of predicting fetal prognosis.