1531例孕妇中高危妊娠脐动脉搏动指数测定联合胎心监护对胎儿预后的评估

Fetal umbilical pulsatitity index and non-stress test for the evaluation of fetal prognosis in high risk pregnancy

目的通过脐动脉搏动指数(PI)测定联合胎心监护(NST)对高危妊娠胎儿预后进行评估,以寻求更为准确可靠的诊断方法。方法将1 531例孕妇中930例高危妊娠妇女分为3组:PI组即PI≥0.9;NST组即NST无反应型组;联合组即PI≥0.9且NST无反应型组进行比较;记录分娩方式和分娩结局即羊水污染,新生儿Apgar评分等指标。结果联合组的羊水污染率、新生儿窒息率及剖宫产率明显高于PI组以及NST组。当PI≥0.9时,胎儿预后不良发生率明显高于S/D及RI的发生率。结论在进行脐血流监测时,PI值优于S/D及RI值。PI值与胎心监护联合应用,为产科医师正确评估胎儿宫内状况,判断胎儿预后的估计提供可靠依据,不失为值得推广并加以重视的无创、简便、动态的胎儿监护方法。

Aim To evaluate about fetal prognosis in high risk pregnancy in order that more accuratel and reliable diagnostic methods may be found.Method 930 patients were divided for testing into three groups：the pulsatitity index group（pulsatitity index（PI）≥0.9）,the NST group（single group of adiaphoria NST）,the combining group（PI≥0.9 and adiaphoria NST）.All subjectives of delivery were partly realized.Meconium staining,Apgar score etc were recorded.Results The combining group had a significantly higher rate than the pulsatitity index group and adiaphoria NST group in meconium staining,asphyxia of newborn and abdominal delivery.The rate of fetal poor prognosis was significantly higher than S/D and RI,when PI was higher than or equal to 0.9.Conclusion PI is prior to S/D and RI in fetal umbilical blood flow examination.Fetal umbilical pulsatitity index coupled with monitoring of non-stress test can provide credible evidence for obstetric doctor in the way of correct evaluation for fetal condition and judgement for prognosis,so it is a simple,noinvasive and dynamic fetal surveillance.