远程胎儿监护在脐带绕颈孕妇产前自我保健中的作用

Value of long-distance fetal heart rate monitoring on the pre-partum health care of the pregnant woman with umbilical cord loops

目的 探讨远程胎儿监护对提高脐带绕颈孕妇产前保健质量的作用。方法 根据家庭自我监护方式的不同 ,将脐带绕颈的孕妇分为试验组和对照组 ,试验组 (896例 )为远程胎儿监护和胎动计数者 ;对照组 (1914例 )为单纯胎动计数者。分别统计两组无负荷试验 (NST)、胎儿宫内窘迫、新生儿窒息、医院内外死胎、死产的资料。结果 试验组远程NST为反应型、无反应型和变异减速频繁发生的百分率 (分别为 2 5 6 %、16 1%、5 9 1% )与试验组常规NST(分别为 33 7%、11 5 %、33 4 % )和对照组常规NST(分别为 30 8%、12 1%、31 8% )比较 ,差异均有显著性 (P <0 0 5 ) ;试验组和对照组常规NST比较 ,差异无显著性 (P >0 0 5 )。试验组胎儿宫内窘迫检出率 (35 0 % )较对照组 (30 9% )明显升高 (P <0 0 5 ) ;试验组新生儿窒息的发生率 (3 5 % )较对照组 (5 6 % )明显降低 (P <0 0 5 )。医院外试验组死胎发生率 (0 1% )较对照组 (0 8% )明显降低 (P <0 0 1) ;两组医院内死胎发生率比较 ,差异无显著性 (P >0 0 5 ) ;两组间分娩方式比较 ,差异无显著性 (P >0 0 5 )。结论 远程胎儿监护可降低脐带绕颈孕妇新生儿窒息的发生率 ,减少医院外死胎的发生率 ;对手术产率无明显影响。远程胎儿监护为脐带绕颈孕妇家庭自?

Objective To explore the value of the long distance fetal heart rate (FHR) monitoring on the pre partum health care of self monitoring at home for pregnant woman with the umbilical cord loops Methods The umbilical cord loops was diagnosed by ultrasonography In the study group, 896 pregnant women with the umbilical cord loops accepted long distance FHR monitoring and the count of fetal movement (FM) as family self monitoring methods, while in the control group, 1 914 pregnant women with the umbilical cord loops used the count of FM only as family self monitoring method Abnormal non stress test (NST), variable deceleration, fetal distress, neonate asphyxia, fetal death, stillbirth, operative delivery rate were analyzed between the study and control group retrospectively Results The incidence of NST reactive pattern and non reactive pattern and the variable deceleration in long distance FHR monitoring of the study group were significantly higher than those in routine FHR monitoring The incidence of fetal distress in the study group (35 0%) was significantly higher than that in the control group (30 9%), while the incidence of neonatal asphyxia in the study group (3 5%) was significantly lower than that in the control group (5 6%) The incidence of outside hospital fetal death in the study group (0 1%) was significantly lower than that in the control group (0 8%) There were no significant differences of cesarean section rate, forceps or vacuum extractor delivery between the two groups ( P >0 05) Conclusions This study suggested that the high variable rate in the long distance FHR monitoring curve was related to the incidence of the fetal distress It didn′t increase the cesarean section rate and vaginal operative delivery rate, but decreased the neonatal asphyxia and outside hospital fetal death rate The long distance FHR monitoring combined with the count of FM may be a better family self monitoring method for the pregnant women with the umbilical cord loops