第一产程胎心监护异常变异与分娩结局的关系探讨

Relationship Between Abnormal Variation of Fetal Heart Rate Monitoring in the First Stage of Labor and Delivery Outcome

目的探讨第一产程胎心监护异常变异与分娩结局的关系.方法回顾性收集2016—2020年与我院进行分娩的女性436例,依据第一产程是否出现胎心率(FHR)图形异常分为正常组231例和异常组205例.对正常组和异常组对象分娩情况进行比较;并对异常组FHR图形异常进行统计,探讨不同异常情况下新生儿窒息发生情况.结果两组分娩方式构成和羊水污染、脐带绕颈、新生儿窒息发生率差异有统计学意义(P<0.05).图形变异发生率前五位:轻度变异减速(VD)为53.17%;早期减速(ED)为31.22%;晚期减速(LD)为6.34%;基线变异减弱为3.90%;重度V D为2.93%(6/205).其中,LD、基线变异减弱和重度VD是新生儿窒息的危险因素.结论第一产程胎心监护异常变异可早期预示不良分娩结局,尤其是LD、基线变异减弱和重度VD,预示着新生儿窒息风险增加.

Objective To explore the relationship between abnormal variation of fetal heart rate monitoring in the first stage of labor and delivery outcome.Methods A total of 436 women who delivered in our hospital from 2016 to 2020 were retrospectively collected and divided into normal group(231 cases)and abnormal group(205 cases)according to whether abnormal fetal heart rate(FHR)appeared in the first stage of labor.We compared the delivery situation of normal group and abnormal group,and analyzed the abnormal FHR figure of abnormal group,and explored the incidence of neonatal asphyxia under different abnormal conditions.Results There were significant differences in the mode of delivery,amniotic fluid pollution,umbilical cord around the neck and neonatal asphyxia between the two groups(P<0.05).The top five incidence of pattern variation:mild VD was 53.17%;Ed was 31.22%;LD was 6.34%;baseline variation decreased to 3.90%;and severe VD was 2.93%(6/205).LD,decreased baseline variation and severe VD were risk factors for neonatal asphyxia.Conclusion Abnormal variation of fetal heart rate monitoring in the first stage of labor can predict early adverse delivery outcomes,especially LD,decreased baseline variation and severe VD,which indicates increased risk of neonatal asphyxia.