基于物联网的胎心监护系统在孕晚期羊水量过少孕妇胎儿监测中的应用研究

目的:探讨基于物联网的胎心监护系统在孕晚期羊水量过少孕妇胎儿监测中的应用。方法:将2019年6月—2020年6月商丘市妇幼保健院产科收治的68例孕晚期羊水量过少孕妇设为对照组,将2020年7月—2021年7月收治的70例孕晚期羊水量过少孕妇设为观察组。对照组孕妇采用传统产前监护,观察组孕妇采用基于物联网的胎心监护系统实施监护。比较两组孕妇胎动异常发生率、新生儿无刺激性胎心监护(NST)异常检出率、孕妇不良妊娠结局及孕妇胎心监护满意度。结果:观察组新生儿NST异常检出率高于对照组,差异有统计学意义(U=9.992,P<0.05)。观察组胎动异常发生率比较,差异无统计学意义(χ^(2)=0.032,P>0.05)。观察组新生儿窒息发生率、早产发生率低于对照组,差异有统计学意义(χ^(2)=6.356、2.630,P<0.05);两组产妇不良妊娠结局中中转剖宫产率、新生儿吸入羊水发生率、产后出血发生率、术后感染发生率、新生儿缺血缺氧性脑病发生率比较,差异无统计学意义(χ^(2)=0.708、0.239、0.759、0.183、0.371,P>0.05)。观察组孕妇胎心监护满意度高于对照组,差异有统计学意义(χ^(2)=8.742,P<0.05)。结论:基于物联网的胎心监护系统可有效提高孕晚期羊水量过少孕妇胎儿的监测效果,有效降低孕妇不良妊娠结局发生率,提高孕妇胎心监护满意度。

The Diagnostic Accuracy of Automated Fetal Heart Echocardiography by Five Dimensional Compared to Two-Dimensional Ultrasound in the Second Trimester of Pregnancy

Objective: To compare the diagnostic accuracy of Fetal Intelligent Navigation Echocardiography (FINE) method by Five-Dimensional Ultrasound in automated fetal heart examination to conventional fetal heart examination by Two-Dimensional ultrasound in second trimester pregnancy. Methods: 90 normal singleton pregnancies at the second trimester were enrolled in this prospective study. Fetal heart was examined by Two-Dimensional Ultrasound (2D US) and Five-Dimensional Ultrasound (FINE). Paired numerical data were compared using the paired samples t test. Inter-method agreement for the rating of the quality of cardiac views by 2D US or 5D US was assessed by calculation of the prevalence-adjusted and bias-adjusted kappa coefficient (PABAK). Results: There was no statistical significant difference between fetal heart echocardiography assessment using 2DUS or 5DUS(FINE) (p-value > 0.05). The overall inter-method agreement between 2D US and 5D US was 0.92. The difference in % of satisfactory views between 2D and 5D US was 1.73%, (95% CI - 0.5% to 3.33%) (P-value = 0.144). Conclusion: Our findings indicate the accuracy of 5DUS (FINE) echocardiography in evaluation of normal heart in the second trimester of pregnancy.

胎心监护联合脐血流检测预测胎儿宫内窘迫的临床价值

目的对于胎心监护和脐血流联合应用在检测早期胎儿宫内窘迫方面的临床效果进行探讨研究。方法在2017年6月—2018年5月期间,从该院妇产科中选取120名单胎孕妇作为研究对象,将其随机分为两组。一组为联合检查组,该为实验组;而另一组为单一检查组,该为对照组。对对照组的孕妇采用常规的胎心监护技术进行检测;对实验组的孕妇采用胎心监护和脐血流综合方法进行监测;然后对这两组孕妇的胎儿的胎心和脐血流的监测结果进行对比分析。结果实验组的胎儿宫内窘迫检测率为16.6%(10/60),对照组胎儿宫内窘迫检测率为5.0%(3/60),差异有统计学意义(χ^2=11.392,P<0.05)。实验组孕妇胎儿的的胎心监护和脐血流的异常检测率均高于对照组,差异有统计学意义(P<0.05)。结论对孕妇使用胎心监护与脐血流联合检测,可以有效提高预测胎儿宫内窘迫的正确率,及时发现孕妇宫内胎儿窘迫情况,改变妊娠结局,临床意义重大。