最新胎心监护分级中Ⅱ类图形的妊娠结局分析

Analysis of pregnancy outcome of categoryⅡfetal heart rate tracing

目的根据最新电子胎心监护图形,探讨胎心监护Ⅱ类图形的潜在风险。方法将2011年11月至2012年10月在该院住院分娩的400例产妇的产前胎心监护分别归类,对其中Ⅰ类(对照组)及Ⅱ类(观察组)胎心监护图形的妊娠结局进行比较。结果观察组产妇中出现羊水污染、剖宫产、羊水少、脐带异常病例数明显高于对照组,差异有统计学意义(P<0.05);新生儿窒息、胎盘老化及新生儿死亡例数与对照组比较,差异无统计学意义(P>0.05);各种胎心监护异常中变异减少组中的羊水污染率高于胎心过速组,差异有统计学意义(P<0.05),胎心过速组中的羊水污染率高于延长加速与无效加速组,差异有统计学意义(P<0.05),其余组间比较妊娠结局差异无统计学意义(P>0.05)。结论Ⅱ类胎心监护图形相比Ⅰ类胎心监护图形对胎儿预示着潜在风险,需加强产前及产时的胎心监护。

Objective To explore the potential risk of category Ⅱ fetal heart rate（FHR） tracing according to the latest electron- ic fetal monitoring tracings. Methods The prenatal fetal heart rate tracings in 400 parturients with hospitalized delivery in this hos- pital from November 2011 to October 2012 were classified by category. Among them,the pregnancy outcomes were compared be- tween the category I FHR tracings（control group） and category Ⅱ FHR tracings（observation group）. Results The case number of meconium-staining amniotic fluid,cesarean rate, hypamniony and umbilical cord abnormality was significantly higher than that of the control group with statistical difference between the two groups（P〈0.05） ;the case number of neonatal asphyxia, aging of pla- centa and neonatal death had no statistical difference between the two groups（P〉0.05） ;among the groups with various fetal heart monitoring abnormalities,the rate of meconium-staining amniotic fluid in the decreased variation group was significantly higher than that in the fetal tachycardia group, the difference showing statistical significance（P〈0.05） ;the rate of meconium-staining amniotic fluid in the fetal tachycardia group was significantly higher than that in the prolonged acceleration and ineffective acceleration group with statistical difference（P〈0.05）;the pregnant outcomes had no statistical differences among the other groups. Conclusion Compared with the category I FHR tracings,the category Ⅱ FHR tracings indicate a potential risk to the fetus,which need to strengthen the prenatal and intrapartum fetal monitoring.