足月妊娠NST无反应型孕妇临产后的胎心变化趋势及其对母婴结局的影响

Fetal heart trend in no reactive NST full-term pregnancy women after childbirth and influence of maternal-infant outcome

目的探索足月妊娠NST反复无反应型孕妇临产后的胎心变化趋势及其对母婴结局的影响。方法选取2014年9月~2015年8月本院收治的NST两次无反应的78例孕妇作为实验组,同时随机选取同期NST有反应的86例孕妇作为对照组。分析两组孕妇临产后持续胎心监护图形变化情况,并观察两组阴道分娩、剖宫产、脐带扭转、脐带缠绕、羊水粪染、新生儿窒息等临床指标的差异。结果实验组临产后胎心异常图形的发生率高于对照组（P〈0.01）,其中胎心异常38.46%,变异减速21.79%,早期减速2.55%,晚期减速5.12%,基线异常5.12%,变异差3.85%;实验组的阴道分娩率为67.94%,低于对照组的91.86%（P〈0.01）,而剖宫产率以及脐带扭转、脐带缠绕、羊水污染、新生儿窒息的发生率均高于对照组,差异有统计学意义（P〈0.01）。结论足月妊娠NST反复无反应型孕妇临产后可出现以变异减速为主的各类异常图形,其剖宫产、新生儿窒息等不良母婴结局的发生风险高于NST有反应型孕妇,临床上应足够重视该类患者。

Objective To investigate the fetal heart trend in no reactive NST full-term pregnancy women after childbirth and influence of maternal-infant outcome. Methods 78 cases of twice no reactive NST pregnant women admitted into our hospital from September 2014 to August 2015 were selected as experimental group,at the same time,86 cases of reactive NST pregnant women were selected as control group.Continuous fetal heart rate tracing patterns in two groups were analyzed,and the differences of clinical index of vaginal delivery,cesarean section,umbilical cord torsion,cord entanglement,meconium-stained amniotic fluid,neonatal asphyxia were observed. Results The incidence rate of abnormal tracing patterns in experimental group was higher than that of control group（P〈0.01）,with fetal heart abnormal of 38.46%,variable decelerations of 21.79%,early deceleration of 2.55%,late deceleration of 5.12%,abnormal baseline of5.12% and variation difference of 3.85%.The rate of vaginal delivery in experimental group was 67.94%,which was significantly lower than 91.86% of control group（P〈0.01）.However,the rate of cesarean section,cord entanglement,umbilical cord torsion,meconium-stained amniotic fluid and neonatal asphyxia in experimental group were significantly higher than those of control group（P 〈0.01）. Conclusion The images of no reactive NST full-term pregnancy women after childbirth may present all kinds of abnormal patterns with variable decelerations taking the most.The risk adverse of maternal-infant such as cesarean section,and neonatal asphyxia were higher than the reactive NST pregnant women,and should pay enough attention to those kind of patient in clinic.