急性和慢性胎儿窘迫新生儿的脐动脉血气及预后的比较

Comparison of umbilical arterial blood gas and prognosis between neonates with acute and chronic fetal distress

目的比较急性和慢性胎儿窘迫新生儿的脐动脉血气及预后。方法将360例单胎孕妇及其分娩的新生儿,根据胎儿窘迫的发生情况及分类分为急性胎儿窘迫组(急性组)、慢性胎儿窘迫组(慢性组)及无胎儿窘迫组(对照组)各120例。3组均于新生儿娩出时抽取脐动脉血进行血气分析。比较3组的脐动脉血气分析指标、新生儿出生后1 min Apgar评分及窒息发生率。结果慢性组的pH、剩余碱均低于急性组与对照组,且对照组、急性组、慢性组新生儿出生后1 min Apgar评分依次降低,而新生儿窒息的发生率依次升高(均P<0.05)。结论与急性胎儿窘迫相比,慢性胎儿窘迫更容易导致新生儿酸中毒及窒息。

Objective To compare umbilical arterial blood gas and prognosis between neonates with acute and chronic fetal distress.Methods Totally 360 women with singleton pregnancy and their neonates were included,and were divided into acute fetal distress group(acute group,n=120),chronic fetal distress group(chronic group,n=120)and non-fetal distress group(control group,n=120)according to the occurrence and classification of fetal distress.In the three groups umbilical artery blood was collected for blood gas analysis when the neonates were delivered.The indexes of umbilical arterial blood gas analysis,neonatal 1-minute Apgar score after birth,and incidence rate of neonatal asphyxia after birth were compared among the three groups.Results The chronic group had lower pH value and base excess than the acute group or control group,and after birth,neonatal 1-minute Apgar score decreased but the incidence rate of neonatal asphyxia increased in the order of the control group,the acute group and the chronic group(all P<0.05).Conclusion Chronic fetal distress causes neonatal acidosis and asphyxia more easily than acute fetal distress.