268例胎心监护可变减速临床分析

Clinical analysis of 268 cases of fetal heart monitoring with variable deceleration

目的:通过对268例胎心监护为可变减速(VD)的足月临产产妇分娩结局及新生儿结局分析,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:回頋2009年1月～2011年7月在我院分娩的产妇,产时胎心监护为可变减速268例患者为研究对象,其中单纯可变减速的147例(单纯型),复杂型121例(复杂型),正常胎心监护患者186例为对照组。比较分析3组间孕妇分娩结局及新生儿结局。结果:新生儿窒息发生率、羊水过少及胎儿生长受限发生率:复杂型组与单纯型组和对照组比较,差异有统计学意义;单纯型组与对照组比较,差异无统计学意义。脐带缠绕发生率:单纯型及复杂型组与对照组比较,差异有统计学意义;单纯型组与复杂型组比较,差异无统计学意义。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。

Objective：To conclude the heart monitoring variable deceleration causes and evaluation of fetal prognosis by analyzing the birth outcomes and neonatal outcomes of 268 cases of fetal heart monitoring for variable deceleration of the full - term parturient women. Methods：Reviewing the maternal birth in our hospital from 2009 January to 2011 July, we choose 286 pregnant women, whose intrapartum fetal heart monitoring for variable declaration, as the object of studying which 147 cases simple variable deceleration （ simple type ） , 121 cases of complex （ complex ） 186 cases of normal fetal heart monitoring as the control group. Compare the outcomes of 3 groups of pregnant women and neonatal. Results ： The rate of neonatal asphyxia ： oligohydramnios and FGR complex group and simple group and the control group, there were significant differences; simple group compared control group, no significant difference. The rate of umbilical cord entanglement： simple group and complex group and control group, there were significant differences; the simple group and complex, no significant difference. Conclusions： The intrapartum fetal heart variable deceleration caused by umbilical cord winding majority, followed by oligopydramnios and fetal growth restriction; simple variable deceleration neonatal outcomes than the complex. Complex variable deceleration often associated with oilgohydramnios and fetal growth restriction, the occurrence of neonatal adverse outcomes possibility is big.