多模式健康教育结合胎心监护在胎儿窘迫孕产妇中的应用效果

Effect of multi-mode health education combined with fetal heart monitoring on pregnant women with fetal intrauterine distress

目的结合临床实践经验,探讨多模式健康教育结合持续胎心监护在胎儿窘迫孕产妇中的应用效果。方法本研究为前瞻性随机对照试验。选取2019年5月至2021年8月郑州市妇幼保健院收治的胎儿窘迫孕产妇86例,随机分为联合组和传统组,联合组43例,年龄(26.38±3.02)岁,孕周(38.17±3.92)周;传统组43例,年龄(29.64±3.18)岁,孕周(38.21±3.86)周。传统组给予常规胎心监护措施,联合组给予多模式健康教育结合持续胎心监护。比较两组孕产妇妊娠结局,并对干预前后两组胎心率、胎动次数、24 h尿雌三醇进行比较,比较两组孕产妇并发症发生情况、干预前后负性情绪、孕产妇满意度。统计学方法采用独立样本t检验、配对t检验、χ^(2)检验。结果联合组孕产妇剖宫产、新生儿黄疸、妊娠高血压、羊水过多发生率均低于传统组[27.91%(12/43)比53.49%(23/43)、6.98%(3/43)比27.91%(12/43)、18.60%(8/43)比48.84%(21/43)、4.65%(2/43)比20.93%(9/43)],差异均有统计学意义(χ^(2)=5.830、6.541、8.792、5.108,均P<0.05)。干预前两组孕产妇胎心率、胎动次数、24 h尿雌三醇比较差异均无统计学意义(均P>0.05);干预后联合组孕产妇胎心率、胎动次数和24 h尿雌三醇均高于传统组,差异均有统计学意义(均P<0.05)。联合组孕产妇并发症发生率低于传统组[4.65%(2/43)比23.26%(10/43)],差异有统计学意义(χ^(2)=6.198,P=0.013)。干预后联合组孕产妇焦虑自评量表(SAS)和抑郁自评量表(SDS)评分均低于传统组(均P<0.05)。联合组孕产妇总满意度高于传统组[97.67%(42/43)比86.05%(37/43)],差异有统计学意义(χ^(2)=12.863,P=0.002)。结论多模式健康教育结合胎心监护可改善胎儿窘迫孕产妇妊娠结局,降低并发症发生率,改善孕产妇焦虑抑郁情绪,孕产妇满意度较高,值得进一步推广应用。

Objective To discuss the application effect of multi-mode health education combined with fetal heart monitoring on pregnant women with fetal distress based on clinical experiences.Methods It was a prospective randomized controlled trial.A total of 86 pregnant women with fetal distress admitted to Women and Infants Hospital of Zhengzhou from May 2019 to August 2021 were selected and randomly divided into a combined group and a traditional group.In the combined group,43 pregnant women were(26.38±3.02)years old and the gestational age was(38.17±3.92)weeks.In the traditional group,43 pregnant women were(29.64±3.18)years old and the gestational age was(38.21±3.86)weeks.The traditional group was given routine fetal heart monitoring measures,and the combined group was given multi-mode health education combined with continuous fetal heart monitoring intervention.The pregnancy outcomes of the two groups were compared.The fetal heart rate,fetal movement times,and 24 h urinary estriol were compared between the two groups before and after intervention.The incidences of maternal complications in the two groups were counted.The negative emotions were compared between the two groups before and after intervention,and the maternal satisfaction was counted.Independent sample t test,paired t test,and χ^(2) test were used for statistical analysis.Results The incidences of cesarean section,neonatal jaundice,pregnancy-induced hypertension,and hydramnios in the combined group were lower than those in the traditional group[27.91%(12/43)vs.53.49%(23/43),6.98%(3/43)vs.27.91%(12/43),18.60%(8/43)vs.48.84%(21/43),4.65%(2/43)vs.20.93%(9/43)],with statistically significant differences(χ^(2)=5.830,6.541,8.792,and 5.108;all P<0.05).Before intervention,there were no statistically significant differences in the fetal heart rate,fetal movement times,and 24 h urinary estriol between the two groups(all P>0.05).After intervention,the fetal heart rate,fetal movement times,and 24 h urinary estriol in the combined group were higher than those in the traditional group,with statistically significant differences(all P<0.05).The incidence of maternal complications in the combined group was lower than that in the traditional group[4.65%(2/43)vs.23.26%(10/43)],with a statistically significant difference(χ^(2)=6.198,P=0.013).After intervention,the scores of Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)in the combined group were lower than those in the traditional group(both P<0.05).The total satisfaction of the combined group was higher than that of the traditional group[97.67%(42/43)vs.86.05%(37/43)],with a statistically significant difference(χ^(2)=12.863,P=0.002).Conclusion Multi-mode health education combined with fetal heart monitoring can improve the pregnancy outcomes in pregnant women with fetal distress,reduce the incidence of complications,and improve their anxiety and depression moods,with high maternal satisfaction,which is worthy of further application.