动态监测脐动脉血流及胎心监护在高危孕妇的胎儿窘迫诊断中的价值分析

Value analysis of dynamic monitoring of umbilical artery blood flow and fetal heart monitoring in the diagnosis of fetal distress in high-risk pregnant women

目的分析动态监测脐动脉血流及胎心监护在高危孕妇的胎儿窘迫诊断中的临床价值。方法选择2015年7月~2017年3月在我院就诊的高危孕妇150例,均接受动态监测脐动脉血流及胎心监护,按照脐动脉血流正常及胎心率正常、脐动脉血流正常及胎心率异常、脐动脉血流异常及胎心率正常、脐动脉血流及胎心率均异常,分为A组(88例)、B组(15例)、C组(20例)、D组(27例),共四组,分析羊水、胎儿窘迫及新生儿情况。结果 D组羊水过少率、胎儿窘迫率、新生儿Apgar评分均高于A组(P<0.05);D组胎儿脐带绕颈率高于A组(P<0.05);B组羊水过少、胎儿窘迫及羊水污染发生率均高于A组,剖宫产率也高于A组(P>0.05);B组胎儿脐带绕颈率低于A组(P<0.05);B组剖宫产率高于C组(P>0.05)。结论单独或联合使用动态监测脐动脉血流及胎心监护均能够及时发现胎儿窘迫情况,有利于改善新生儿预后,临床实践中建议联合使用,从而提高胎儿窘迫阳光检出率。

Objective To analyze the clinical value of dynamic monitoring of umbilical artery blood flow and fetal heart monitoring in the diagnosis of fetal distress in high-risk pregnant women. Methods One hundred and fifty highrisk pregnant women who were treated in our hospital from July 2015 to March 2017 were selected to receive dynamic monitoring of umbilical artery blood flow and fetal heart monitoring.According to normal umbilical artery blood flow and normal fetal heart rate, normal umbilical artery blood flow and abnormal fetal heart rate,abnormal umbilical artery blood flow and normal fetal heart rate,abnormal umbilical artery blood flow and abnormal fetal heart rate,they were divided into group A（88 cases）,group B（15 cases）,group C（20 cases） and group D（27 cases）,totally four groups.Amniotic fluid,fetal distress and neonatal conditions were analyzed. Results The oligohydramnios rate,fetal distress rate and neonatal Apgar score in group D were all higher than those in group A（P〈0.05）.The rate of umbilical cord around neck in group D was higher than that in group A（P〈0.05）. The incidence of oligohydramnios,fetal distress and amniotic fluid pollution in group B were higher than those in group A,and the rate of cesarean section was higher than that in group A（P〈0.05）.The rate of umbilical cord around neck in group B was lower than that in group A（P〈0.05）,and the rate of cesarean section in group B was higher than that in group C（P〈0.05）. ConclusionSingle or combined use of dynamic monitoring of umbilical artery blood flow and fetal heart monitoring can detect fetal distress in time and improve the prognosis of newborns.In clinical practice,combined use should be suggested to improve the detection rate of fetal distress.