孕期甲胎蛋白持续增高对围产儿结局的影响

Effect of continuous increase of alpha fetoprotein during pregnancy on perinatal outcome

目的:探讨孕妇血清甲胎蛋白值持续增高与胎儿宫内缺氧及围产儿预后的关系。方法:以2006年7月～2010年6月门诊建立孕妇保健手册、检测血清甲胎蛋白值持续增高的76例孕妇作为观察对象(监测组),随机抽取同期建卡的孕妇150例作为对照组,比较两组胎儿宫内窘迫、新生儿窒息、新生儿缺血缺氧性脑病的发生率及剖宫产率。结果:监测组胎儿宫内窘迫、新生儿窒息、新生儿缺血缺氧性脑病的发生率均明显高于对照组(P<0.05),其剖宫产率亦高于对照组(P<0.01)。结论:孕妇甲胎蛋白持续增高提示胎儿存在宫内缺氧,需及时予以改善宫腔内环境及缺氧状态,临产时应放宽手术指征,尽快结束妊娠并对新生儿及时进行治疗,以减少围产儿不良结局。

Objective：To explore the relationship between continuous increase of alpha fetoprotein and intrauterine hypoxia of fetuses and prognosis of perinatal infants. Methods：76 pregnant women who built maternal health care handbooks in outpatient department of the hospital from July 2006 to June 2010 were selected as study objects,their serum alpha fetoprotein values increased continuously;150 pregnant women who built maternal health care handbooks at the same time were selected randomly as control group.The incidences of fetal intrauterine hypoxia,neonatal asphyxia and neonatal hypoxic ischemic encephalopathy and cesarean section rates in the two groups were compared. Results：The incidences of fetal intrauterine hypoxia,neonatal asphyxia and neonatal hypoxic ischemic encephalopathy in monitoring group were significantly higher than those in control group（P〈0.05）,the cesarean section rate in monitoring group was also significantly higher than that in control group（P〈0.01）. Conclusion：The continuous increase of alpha fetoprotein of pregnant women indicates the existence of fetal intrauterine hypoxia,the intrauterine circumstance and hypoxic status should be improved timely,the surgical indications should be loosed near the time of labor,terminating pregnancy and treating the neonates timely may reduce adverse pregnancy outcome of perinatal infants.