胎心监护不同时限发生延长减速的临床意义

The clinical value of prolonged decelerations of fetal heart rate in different stages

目的探讨不同时限发生的延长减速与新生儿结局的关系。方法观察3 218例单胎孕足月产妇,将胎心监护提示有延长减速的890例单胎孕产妇按照延长减速发生的时限分为临产前、活跃期、第二产程,分析不同时限延长减速的发生率、剖宫产率以及从延长减速发生至终止妊娠或分娩的时间对新生儿结局的影响。结果随着妊娠和产程的发展,胎儿延长减速的发生率逐渐增加,而剖宫产率却呈下降趋势。从延长减速发生至分娩的时间越短,新生儿的预后越好。结论子宫收缩、胎头下降可以诱发延长减速的发生,出现延长减速至胎儿娩出时间的长短与新生儿预后密切相关。

Objective To discuss the clinical value of fetal prolonged decelerations of heart rate in different stages. Methods A to- tal of 3 218 pregnant women were observed, 890 of whom occured prolonged decelerations. These cases were further subdivided into three study stages and phases ： prelabor stage, active phases, and second stage of labor. Incidence of prolonged decelerations and ratio of cesarean section were analyzed respectively. The relationship between new born infant assessment and the lasting time from prolonged decelerations oc- currence to labor ending were analyzes. Results With the progress of labor and delivery stages, the incidence of prolonged decelerations was elevated while ratio of cesarean section was decelerated. Sooner for delivery, the better for fetal and the less necessary for cesarean section.Conclusion Uterine contractions and descending fetal head induce the occurrence of prolonged decelerations. The lasting time from pro- longed decelerations occurrence to labor ending is closely related to the neonatal cuteome.