新冠疫情期间胎心监护模式对高危妊娠的影响探讨

Discussion on the influence of fetal heart rate monitoring mode on high-risk pregnancy during COVID-19 epidemic

目的探讨新冠疫情期间远程胎心监护和传统胎心监护两种不同模式对高危妊娠的影响.方法收集2020年1月至2020年6月在广东中山市博爱医院接受检查的单胎妊娠孕妇5352例,按照胎心监护形式分为传统胎监组(A组)3312例和远程胎监组(B组)2040例.其中,A组根据高危孕妇诊断标准分为传统胎监高危组(A1组)1405例和传统胎监低危组(A2组)1907例;同样B组分为远程胎监高危组(B1组)716例和远程胎监低危组(B2组)1324例.对比不同组间妊娠结局.结果A组和B组的剖宫产率分别为35.21%和40.49%,两组剖宫产率差异有统计学意义(P<0.05).A1组和B1组剖宫产率分别为50.68%和46.79%,两组剖宫产率差异无统计学意义(P>0.05);A1组和B1组足月产率分别为86.05%和91.48%,两组相比差异有统计学意义(P<0.05);A1组和B1组新生儿转科率分别为9.11%和4.61%,两组相比差异有统计学意义(P<0.05);A1组和B1组分娩孕周分别为(38.11±2.02)周和(38.42±1.62)周,两组相比差异有统计学意义(P<0.05).A2组和B2组剖宫产率分别为23.81%和37.08%,两组相比差异有统计学意义(P<0.05);A2组和B2组足月产率分别为92.76%和90.79%,两组相比差异有统计学意义(P<0.05);A2组和B2组新生儿转科率分别为5.56%和7.40%,两组相比差异有统计学意义(P<0.05);A2组和B2组分娩孕周分别为(38.63±1.78)周和(38.48±1.62)周,两组相比差异有统计学意义(P<0.05).结论互联网远程胎心监护可使高危妊娠孕妇在家中得到良好的胎心监测,改善围产儿预后,同时不增加剖宫产率,具有临床应用价值.

Objective To explore the impact of remote fetal heart rate monitoring and traditional fetal heart rate monitoring on high-risk pregnancy during COVID-19 epidemic.Methods A total of 5 352 singleton pregnant women who were examined inBoai Hospitalin Zhongshan City, Guangdong from January 2020 to June 2020 were collected. According to the form of fetal heart rate monitoring,they were divided into traditional fetal monitoring group(group A)3 312 cases,and remote fetal monitoring group(group B)2 040 cases. Among them,group A was divided into traditional fetal monitoring high-risk group(group A1) 1 405 cases and traditional fetal monitoring low-risk group(group A2) 1 907 cases according to the diagnostic criteria of high-risk pregnant women;as the same,group B was dirided into remote fetal monitoring high-risk group(group B1)716 cases,and 1 324 cases in the remote fetal monitoring lowrisk group(group B2). Compared pregnancy outcomes between different groups.Results The cesarean section rates of group A and group B were 35. 21% and 40. 49%,respectively,and the difference in cesarean section rate between the two groups was statistically significant(P<0. 05). The cesarean section rates in group A1 and B1 were 50. 68% and 46. 79%,respectively. There was no significant difference in cesarean section rates between the two groups(P>0. 05). The full-term birth rates in group A1 and B1 were 86. 05% and91. 48%,respectively. The difference between the two groups was statistically significant(P< 0. 05). The transfer rates of newborns in group A1 and B1 were 9. 11% and 4. 61%,respectively,and the difference between the two groups was statistically significant(P<0. 05). The gestational weeks of delivery in the A1 group and B1 group were(38. 11 ± 2. 02) weeks and(38. 42 ± 1. 62) weeks,respectively. The difference between the two groups was statistically significant(P<0. 05). The cesarean section rates in group A2 and B2 were 23. 81% and 37. 08%,respectively. The difference between the two groups was statistically significant(P<0. 05). The full-term birth rate in group A2 and B2 was 92. 76% and 90. 79%,respectively. The difference between the two groups was statistically significant(P<0. 05). The transfer rate of newborns in the A2 group and the B2 group was 5. 56% and 7. 40%,respectively,and the difference between the two groups was statistically significant(P< 0. 05). The gestational weeks of the A2 group and B2 component were(38. 63 ± 1. 78)weeks and(38. 48 ± 1. 62) weeks,respectively,and the difference between the two groups was statistically significant(P< 0. 05).Conclusion Internet remote fetal heart rate monitoring can enable high-risk pregnant women to get good fetal heart rate monitoring at home,improve the prognosis of the perinatal infant,and at the same time not increase the cesarean section rate,which has clinical application value.