羊膜腔注射地塞米松促胎肺成熟对胎儿的短期影响

目的:探讨有早产倾向的孕妇应用地塞米松后对胎儿的短期影响。方法:2003年1月～2006年1月在该院住院的先兆早产、胎膜早破、妊娠高血压疾病、胎儿宫内生长受限、前置胎盘的病人60例,在超声引导下羊膜腔内注射地塞米松12mg。于注射前及注射后24min内行胎心监护,记录胎心基线、长变异、短变异、胎心加速等指标。结果:观察胎心监护各指标在给药后6～12min这段时间内变化最为明显,于24min左右基本回到给药前水平。结论:羊膜腔注射地塞米松对胎心率基线、长变异、短变异及胎心加速影响明显,这可能是由于药物对胎儿中枢神经系统相应受体及外周血管阻力增加引起的,而胎心加速可能由于胎动增加引起。对慢性宫内缺氧胎儿是否引起耗氧量增加对胎儿造成不利影响仍需进一步研究。

The short term effects of dexamethasone administration in the amniocavity enhancing the fetus

Objective:To research the short term effects of dexamethasone administration to the high risk pregnant women with preterm delivery.Methods:Selecting 60 cases complicating with preterm labor,preterm rupture of membranes,hypertensive disorder complicating pregnancy or intrauterine growth restriction.Under the guiding of ultrasound,we inject dexamethasone into the amniocavity about 12 mg,then monitoring the basal fetal heart rate(BFHR),long term variability(LTV),short term variability(STV)and accelerations(ACC)within 24 hours.Results:Within 6~12 hours postinjection BFHR showed a significant decrease,whereas LTV,STV,ACC significant increase.Conclusion:The short term effects of dexamethasone administration on the fetus in the amniocavity were obvious on BFHR,LVT,SVT and ACC.These changes may due to the binding of corticsteriod to its receptor or increasing vascular resistance.Whether deteriorating the IUGR fetal condition,it's necessary to further research.