脐血流与胎心监护联合监测胎儿宫内窘迫的临床价值

Clinical Value of Umbilical Blood Flow Combined with Fetal Heart Rate Monitoring for Fetal Distress

目的探讨脐血流与胎心监护联合监测胎儿宫内窘迫的临床价值。方法选取我院住院分娩的296例高危妊娠孕产妇分为两组各148例;在胎儿宫内窘迫的监测上,对照组采取胎心监护,观察组采取脐血流与胎心监护联合监测;根据脐血流收缩期峰值流速/舒张末流速(S/D)值、胎心监护对胎儿宫内窘迫的诊断情况,比较两种方案监测胎儿宫内窘迫的灵敏度、特异度、阳性预测值、阴性预测值。结果 S/D值≥3.0、胎心监护异常的胎儿宫内窘迫发生率为42.91%(127/296),新生儿Apgar评分为(9.12±1.45)分,而S/D值及胎心监护正常的新生儿Apgar评分为(9.78±1.29)分(P<0.05)。观察组监测胎儿宫内窘迫的灵敏度、特异度、阳性预测值、阴性预测值均显著高于对照组(P<0.05)。结论脐血流与胎心监护联合监测可协同提高对胎儿宫内窘迫的诊断水平,减少假阳性、假阴性的发生率,可用于早期筛查胎儿宫内窘迫,评估胎儿宫内窘迫的严重程度及预后。

Objective To explore the clinical value of umbilical blood flow combined with fetal heart rate monitoring for fetal distress. Methods A total of 296 cases of pregnant women with high risk in our hospital were divided into two groups, with 148 cases in each group. The control group received fetal heart rate monitoring, while the observation group received umbilical blood flow combined with fetal heart monitoring for fetal distress. The peak systolic velocity / end-diastolic velocity （S/D） value of umbilical blood flow was observed, and the sensitivity, specificity, positive predictive value and negative predictive value of two groups were compared. Results For cases with S/D value ≥ 3.0 and abnormal fetal heart rate monitoring at the same time, the incidence of fetal distress was 42.91% （127/296）, and the neonatal Apgar score was （9.12 ± 1.45） points, significantly lower than （9.78 ±1.29） points of cases with normal S/D value and fetal heart rate monitoring （P 〈0.05）. The sensitivity, specificity, positive predictive value and negative predictive value of observation group were significantly higher than those of control group （P〈0.05）. Conclusions Umbilical blood flow combined with fetal heart rate monitoring can improve the diagnosis of fetal distress, reduce the incidences of false positive and false negative diagnosis, which can be used for early screening of fetal distress, and evaluate the severity and prognosis of fetal distress.