全程胎心监护

Continuous intrapartum fetal heart monitoring

目的 :探讨全程胎心率监护的价值。方法 :对 15 0例产妇进行全程胎心率监护 ,分析胎心率图形与羊水性状 ,新生儿出生后 1min Apgar评分及分娩方式的关系。结果 :胎心率图形 :异常组 4 2例中羊水污染 2 7例 ,正常组 10 8例中羊水污染 17例 ,有明显升高 (χ2 =8.4 7,P<0 .0 0 5 ) ;新生儿出生后 1min Apgar评分≤ 7分 :异常组 10例 ,正常组 2例 ,有明显升高 (χ2 =19.80 ,P<0 .0 0 5 ) ;分娩方式 :异常组顺产 15例 ,正常组 81例 ,两者比较有显著差异 (χ2 =2 0 .2 6 ,P<0 .0 0 5 )。结论 :全程监护有利于筛选胎儿宫内窘迫 ,便于临床掌握分娩时机与选择分娩方式。

Objective: To observe the prognostic value of intrapartum continuous fetal heart monitoring (FHM). Methods: A review of 150 patients who had intrapartum FHM was performed. The relation between fetal heart rate and amniotic fluid condition, newborn Apgar scores, and delivery method was determined. Results: Among the 150 cases,normal fetal heat rates were recorded in 108 cases. The abnormalities in the other 42 cases with abnormal FHM were as follows: cloudy amniotic fluid 27 cases (64.3%) vs 17/108 (15.7%) in the normal FHM group ( P <0.005); 10 cases (23.8%) had Apgar scores ≤7 vs only 2 (1.85%) in the normal FHM group ( P <0.005). In the abnormal FHM group, there were 15 cases (35.7%) of spontaneous labor, 10 cases (23.8%) of forceps delivery and 17 cases (40.5%) of C section vs 81,3, and 24 (75%, 2.8%, and 22.2%) respectively in the normal FHM group ( P <0.005). Spontaneous delivery was more common in the normal FHM (75%) vs abnormal FHM group (35.7%). C section rate was higher in the abnormal FHM group (40.5%) ( P <0.005). Conclusion : Intrapartum fetal heart monitoring detects early fetal distress and thus may lead to earlier intervention such as C section during the perinatal period.