产程中胎儿异常监护图形与新生儿结局的关系

目的:分析产程中宫缩应激试验(CST)、异常胎儿监护图形与羊水粪染和新生儿窒息的关系,探讨早期发现胎儿窘迫的方法。方法:分析1146例足月、单胎、头位分娩的产妇产程中CST评分和异常胎儿监护图形。结果:羊水粪染组(156例)和新生儿窒息组(67例)在第一产程和第二产程CST评分显著低于对照组(923例),减速图形的特点是:细变异减少或消失,伴有晚期减速、重度变异减速、不典型变异减速和延迟减速,并出现混合减速图形。结论:产时CST评分可疑或出现异常胎儿监护图形,如同时伴有细变异减少或消失,是早期诊断胎儿窘迫的重要指标,应引起高度重视,必要时及时终止妊娠。

The relationship between abnormal types of fetal heart rate patterns during labour and neonatal outcomes

Objective:To study the relationship between constriction stress test , abnormal types of fetal heart rate patterns at birth and meconium stained amniotic fluid and neonatal asphyxia and investigate the method of early diagnosis in fetal distress.Methods:To analyse the CST score and abnormal types of fetal heart rate patterns in 1 146 cases of singleton term pregnancy with head delivery.Results:The CST score of group meconium stained amniotic fluid (156 cases) and group of asphyxia neonatorum (67 cases) was significant lower (P<0.01)than that of control group(923 cases) during the first and second stage. The characteristics of decelerations show baseline variability reduced or disappeared along with severe variable decelerations, late decelerations, atypical variable decelerations, prolonged decelerations and mixed decelerations patterns.Conclusion:CST score being abnormal or suspected with abnormal types of fetal heart rate patterns at birth are the main indexes of early diagnosis in fetal distress if it appears with baseline variability reduced or disappeared.More attention should be paid on it and terminate pregnancy promptly if necessary.