活跃期持续胎心监护的临床应用

Clinical Application of Continuous Fetal Heart Rate Monitoring during Active Phase

目的:探讨进入活跃期后进行持续胎心监护的临床意义,以通过持续胎心监护对因宫缩乏力导致活跃期停滞或延迟的产妇选择合适的分娩方式进行指导。方法:选取因宫缩乏力导致活跃期停滞或者延期的产妇114例,使用胎心宫缩监护仪进行持续监护并统计产妇的分娩方式和分娩情况。结果:无减速和早期减速患者均采取自然分娩,97.56%的轻度变异减速者采取自然分娩,而86.96%的中度变异减速患者采取自然分娩,其余患者采取剖宫产或者是助产;而重度变异减速者无采取自然分娩者,大多数采取剖宫产,另有20%者采取助产,不同监测结果采取的分娩方式有统计学差异(P<0.05)。无减速和早期减速产妇脐带绕颈、羊水污染以及新生儿评分<7者明显少于其他产妇(P<0.05);轻度变异减速以脐带绕颈相对较多,而羊水污染明显少于其他产妇(P<0.05);中度变异减速者羊水污染率明显高于其他产妇(P<0.05);重度变异减速者羊水污染明显多于其他产妇(P<0.05)。结论:在活跃期开始对产妇进行持续胎心监护有利于判断胎儿功能状况,从而对选择合适的分娩方式,提高产科医疗质量有着重要的临床意义。

Objective：To investigate into the active phase after the clinical significance of continuous fetal heart rate monitoring, fetal monitoring through continuous uterine inertia due to stagnation or delay resulting active period of maternal select the appropriate mode of delivery for guidance.Methods：Uterine inertia due to active phase arrest or delay resulting maternal 114 cases, the use of continuous fetal heart monitor contractions guardianship and statistical mode of delivery and maternal childbirth.Results：No early deceleration deceleration and patients were taking natural childbirth, 97.56%of mild variable deceleration to take natural childbirth, and 86.96% in patients with moderate variable deceleration taking natural childbirth, cesarean section or other patients taking midwifery;while those without severe variable deceleration take spontaneous labor, most take cesarean, and another 20%to take delivery, monitoring results taken different mode of delivery were significantly different （P〈0.05）. No early deceleration deceleration and maternal cord around the neck, as well as neonatal meconium score〈7 was significantly less than other women （P〈0.05）;mild variable deceleration relatively large cord around the neck, and significantly less than other maternal amniotic （P〈0.05）;moderate variable deceleration by amniotic rate significantly higher than other mothers （P〈0.05）;severe variable deceleration were significantly more than other maternal amniotic （P〈0.05）.Conclusion：Early start in an active ongoing maternal fetal monitoring is conducive to determine the functional status of the fetus, and thus select the appropriate mode of delivery, to improve the quality of obstetric care has important clinical significance.