远程胎儿监护网络用于妊娠肝内胆汁瘀积症晚期监测的价值

目的　探讨远程胎儿监护网络在妊娠肝内胆汁瘀积症 (intrahepatic cholestasis of preg-nancy,ICP)产前监测的临床价值。　方法　采用远程胎儿监护网络 ,对 5 4例 ICP孕妇进行产前无负荷试验 (NST)监测 (研究组 ) ,同期进行常规胎儿监护 (胎动计数和定期到医院进行 NST检查 )的 ICP孕妇 5 4例作为对照 (对照组 ) ,分析两组胎儿监护结果和围产儿结局。　结果　研究组 NST异常检出率 (36 .1% )较对照组 (2 7.2 % )明显增加 (P<0 .0 5 )。研究组 NST异常图形为变异减速、基线变异减少或消失和胎儿心率 (fetal heart rate,FHR)过缓的百分率分别为 4 4 .1%、13.8%和 9.2 % ,与对照组(分别为 2 1.3%、2 9.8%和 2 3.4 % )比较 ,差异均有显著性 (P<0 .0 5 )。研究组新生儿窒息和早产儿的发生率分别为 11.1%和 9.3% ,低于对照组的 2 7.8%和 2 4 .1% (P<0 .0 5 )。两组剖宫产率的差异无显著性 (P>0 .0 5 )。　结论　利用远程胎儿监护网络进行 ICP产前监测 ,可改善围产儿预后 ,是 ICP孕妇自我监护的新选择。

Clinical Value of Remote Electronic Fetal Monitoring Network in Intrahepatic Cholestasis of Pregnancy

Objective To investigate the clinical value of remote electronic fetal monitoring network in intrahepatic cholestasis of pregnancy(ICP). Methods Non-stress test (NST) was carried on in 54 cases of ICP by remote electronic fetal monitoring network(study group). Fifty-four cases of ICP served as control group were monitored by fetal movement counting daily and regular NST check-up in hospital. Abnormal NST and perinatal outcome were compared between the study group and control group. Results The incidence of abnormal NST was significantly higher in the study group than that in the control group ( 36.1% vs 27.2%, P <0.05). There was significant difference in the incidence of variable deceleration, diminished baseline variability or absent variability and bradycardia between the study group(44.1%,13.8% and 9.2%.) and control group(21.3%, 29.8% and 23.4%)( P <0.01). The incidence of preterm birth (11.1%) and neonatal asphyxia (9.3%) in the study group was lower than that in the control group(27.8% and 24.1%)( P < 0.05). There was no significant difference in the rate of cesarean section between the study group and control group( P >0.05). Conclusion Remote fetal monitoring network can be used to improve perinatal outcome of ICP. It is a new method of FHR self-monitoring for ICP case.