285例胎心监护可变减速临床观察

Clinical Analysis of 285 Cases of Fetal Heart Monitoring with Variable Deceleration

目的:通过对285例胎心监护为可变减速的足月临产产妇分娩结局及新生儿结局观察分析,探讨胎心监护可变减速发生原因及对胎儿预后的评价。方法:回顾2009年1月-2012年1月在笔者所在医院分娩的产妇,选择产时胎心监护为可变减速的285例患者为研究对象,其中单纯可变减速的150例(单纯型组),复杂型135例(复杂型组),正常胎心监护患者188例为对照组。比较分析三组孕妇分娩结局及新生儿结局。结果:复杂型组新生儿窒息发生率、羊水过少及胎儿生长受限发生率分别与单纯型组和对照组比较,差异有统计学意义(P<0.05),单纯型组与对照组比较,差异无统计学意义(P>0.05);单纯型组及复杂型组脐带缠绕发生率与对照组比较,差异有统计学意义(P<0.05),单纯型组与复杂型组比较,差异无统计学意义(P>0.05)。结论:产时胎心可变减速发生原因以脐带缠绕居多,其次为羊水过少和胎儿生长受限;单纯型可变减速新生儿结局优于复杂型,复杂型可变减速常合并羊水过少和胎儿生长受限,其新生儿发生不良结局可能性大,应采取果断措施,紧急处理。

Objective： To conclude the heart monitoring variable deceleration causes and evaluation of fetal prognosis by analyzing the birth outcomes and neonatal outcomes of 285 cases of fetal heart monitoring for variable deceleration of the full-lerm parturient women. Method： Reviewing the maternal birth in the hospital from January 2009 to January 2012, to choose 285 pregnant women, whose intrapartum fetal heart monitoring for variable declaration, as the objective of study. In which 150 cases simple variable deceleration （simple type）, 135 cases of complex 188 cases of normal fetal heart monitoring as the control group. To compare the outcomes of the 3 groups of pregnant women and neonatal. Result： For the rate of neonatal asphyxia, oligohydramnios and FGR, there were significant differences between the 3 groups, and simple group, compared to control group, had no significant difference. For the rate of umbilical cord entanglement, there were significant differences between the 3 groups, the simple group, compared to complex, had no significant difference. Conclusion： The intrapartum fetal heart variable deceleration caused by umbilical cord winding majority, followed by oilgohydramnios and fetal growth restriction, simple variable deceleration neonatal outcomes than the complex. Complex variable deceleration often associates with oilgohydramnios and fetal growth restriction, the occurrence of neonatal adverse outcomes is possible.