产时胎心监护异常的处理

Treatment with intrapartum abnormal fetal heart rate monitering

目的 探讨产时胎儿监护异常的常见原因及临床处理。方法 回顾性分析我院因产时胎心监护异常诊断为胎儿宫内窘迫而行剖宫产术的产妇 110例 ,通过行全产程胎心监护寻找不同产程中胎心监护异常的原因 ,对比其新生儿窒息发生率。结果 第一产程发生胎心监护异常行剖宫产者 52例 ,其中高危妊娠 3 6例 ,占69.2 % ;脐带异常 2例 ,占 3 .8%。第二产程发生胎心监护异常行剖宫产者 58例 ,其中高危妊娠 14例 ,占 2 4.1% ;脐带异常 2 1例 ,占 3 6.2 %。两组高危妊娠发生率无显著差异 (P >0 .0 5) ,脐带异常发生率有显著差异 (P <0 .0 1)。产妇中高危妊娠共 50例 ,其中发生新生儿窒息 2 4例 ,占 48.0 % ;脐带异常共 2 3例 ,发生新生儿窒息 3例 ,占 13 .0 %。两组新生儿窒息发生率有显著差异 (P <0 .0 1)。结论 第二产程中胎心监护异常的原因以脐带因素多见 。

ObjectiveTo discuss the common cause and c linical disposal of intrapartum abnormal fetal heart rate monitoring.PPAGESS Methods Retrospectively analysing 110 cases of cesarean sections be cause of fetal distress in uterus diagnosised by fetal heart rate monitoring to found the cause of abnormal fetal heart rate monitering in different stages of l abor through fetal heart rate monitering in whole stages of labor and compare th eir anoxia of newborn rates.Results52 cases of abnormal fetal heart rate monitering were found in the first stage of labor,including 36 cases (69.2%) of high-risk pregnancy and 2 cases (3.8%) of umbilical cord abno rmality.58 cases were found in the second stage of labor ,including 14 cases (24 .1%) of high-risk pregnancy and 21 cases (36.2%) of umbilical cord abnormality. There was no manifested significant difference in high-risk pregnancy rate(P >0.05) and had manifested significant difference in umbilical cord abnormali ty rate(P<0.01).50 cases of high risk pregnancies in all patients were fo und including 24 cases of anoxia of newborn,the incidence of anoxia of newborn w as 48.0%. 23 cases of umbilical cord abnormalities were found including 3 cas es o f anoxia of newborn,the incidence of anoxia of newborn was 13.0%. There was man ifested significant difference in anoxia of newborn rate(P<0.01).Concl usionAbnormal fetal heart rate monitering discovered in the second stage of labor is chiefly caused by umbilical cord abnormality,newborn o utcome is well.