299例孕妇胎心监护无负荷试验中Ⅴ型减速波形的临床分析

Clinical analysis on Ⅴ type decelerating wave in non-stress test of fetal heart monitoring in 299 pregnant women

目的:探讨孕妇胎心监护无负荷试验中V型减速与脐带、羊水及围生儿结局的关系。方法:运用临床资料收集的方法,回顾性总结增城市妇幼保健院2006年1月～2009年10月在该院分娩产妇临产前的胎心监护记录,出现V型减速299例(A组),未出现V型减速的产妇13600例(B组),将两组临床资料进行比较。结果:无负荷试验中V型减速的发生率为2.20%。临产前无负荷试验中出现V型减速的产妇中,各种脐带异常发生率为72.58%,羊水过少发生率为25.75%,羊水Ⅲ度污染发生率为13.38%,胎儿窘迫和新生儿窒息发生率分别为41.81%和10.70%,均显著高于未出现该减速的产妇。结论:临产前无负荷试验出现V型减速的产妇应警惕合并脐带异常和羊水异常,严密监测,及时识别,以防止发生胎儿窘迫和胎死宫内,从而降低围生儿的死亡率。

Objective： To explore the relationship between V type decelerating wave in non - stress test of fetal heart monitoring and umbilical cord, amniotic fluid, perinatal outcomes. Methods： The records of fetal heart monitoring in pregnant women delivering in the hospital from January 2006 to October 2009 were summarized retrospectively, then the pregnant women were divided into A group （299 cases with V type decelerating wave） and B group （ 13 600 cases without V type decelerating wave） , the clinical data of the two group were compared. Results： The incidence of V type decelerating wave in non - stress test of fetal heart monitoring was 2. 20%. Among the pregnant women with V type decelerating wave in non - stress test of fetal heart monitoring, the incidence of umbilical cord abnormalities was 72. 58% , the incidences of oligohydramnios, third grade contaminative amniotic fluid, fetal distress and neonatal asphyxia were 25.75% , 13. 38%, 41.81% and 10. 70%, respectively, there was no difference between the two groups. Conclusion： The pregnant women with V type decelerating wave in non - stress test of fetal heart monitoring should pay attention to umbilical cord abnormality and amniotic fluid abnormality, comprehensive monitoring and timely diagnosis may prevent fetal distress and neonatal asphyxia, and decrease the perinatal mortality.