胎心监护在妊娠期的临床应用价值研究

目的 观察评价胎心监护(fetal heart rate monitoring,FHM)在妊娠期(Pregnancy)的临床应用价值.方法 选择2015年3月至2016年12月于本院就诊的孕妇378例,按照随机对照试验(randomized controlled trial,RCT)分为对照组与观察组,各189例.对照组给予传统胎心听诊诊断;观察组给予产前无应激试验(non stress test,NST)胎心监护(FHM)和产时电子胎心率监护(electronic fetal heart rate monitoring,EFM);比较两组监测方法的诊断正确率.结果 观察组剖宫产率及胎儿宫内窘迫诊断率明显高于对照组(30.16％比15.87％、17.99％比7.94％,x2=10.884 5、8.464 6,均P＜0.05);观察组新生儿窒息率明显低于对照组(3.17％比18.52％,x2=23.007 7,P＜0.05);观察组围产儿死亡0例,对照组1例(0.53％),差异无统计学意义(x2=1.002 7,P＞0.05).观察组孕妇189例经过NST检测结果表明,反应型146例占77.25％(146/189),可疑型29例占15.34％(29/189),无反应型14例占7.41％(14/189).NST评分与胎儿宫内窘迫、新生儿窒息(Neonatal asphyxia)、脐带异常均成反比,说明评分越高,而不良反应发生率则越低.结论 孕妇在产前进行NST胎心监护(FHM)和产时电子胎心监护(EFM)可以完全准确诊断孕妇宫内异常,并且显著地降低新生儿窒息,有效提高新生儿质量.与传统听诊胎心诊断结果相比,其准确性更高,值得产科临床大力推广.

Clinical application of fetal heart monitoring in pregnancy

Objective To evaluate the clinical value of fetal heart rate monitoring (FHM) in pregnancy.Methods 378 pregnant women admitted into our hospital from March,2015 to December,2016 were randomly divided into a control group and an observation group according to randomized controlled trial (RCT),189 cases for each group.The control group were treated with traditional fetal heart hearing auscultation.The observation group were given prenatal stress test (NST) fetal heart rate monitoring (FHM) and electronic fetal heart rate monitoring (EFM).The correct rates were compared between these two groups.Results The cesarean delivery rate and fetal intrauterine distress diagnosis rate were significantly higher and the neonatal asphyxia rate was obviously lower in the observation group than in the control group (30.16％ vs.15.87％,17.99％ vs.7.94％,and 3.17％ vs.18.52％,x2=10.884 5,8.464 6,23.007 7,all P ＜ 0.05).None occurred perinatal mortality in the observation group and 1 case in the control group,with no statistical difference (x2=1.002 7,P ＞ 0.05).In the observation group,NST detection results showed that 146 cases [77.25％ (146/189)] was reaction type,29 cases [15.34％ (29/189)] suspected type accounted,and 14 cases [7.41％ (14/189)] no-reaction type.NST scores was inversely proportional with fetal distress,neonatal asphyxia,and abnormal umbilical cord,indicating that the higher the NST score was the lower the incidence of adverse reactions was.Conclusions If pregnant women take NST FHM and EFM before delivery,intrauterine abnormalities can be accurately diagnosed,neonatal asphyxia significantly reduced,and the quality of newborns improved.Compared with traditional diagnosis and treatment of fetal heart disease,its accuracy is higher,so it is worth being clinically generalized in obstetrics.