远程胎儿监护网络用于高危妊娠监测的临床价值

目的　探讨远程胎儿监护网络监测高危妊娠的价值。方法　选择 116例高危妊娠孕妇 ,采用远程胎儿监护网络进行无负荷试验 (NST)监测 (研究组 ) ,选择同期进行常规胎儿监护 (胎动计数和定期到医院进行NST监测 )的高危孕妇 12 0例作为对照 (对照组 ) ,分析两组胎儿监护的监测结果、新生儿预后和剖宫产情况。结果　研究组孕期胎儿监护次数为 (9 2± 4 9)次 ,明显高于对照组的(2 6± 1 3)次 (P <0 0 0 1) ,而两组监护费用相当。研究组新生儿窒息和早产发生率分别为 10 3%和12 6 % ,低于对照组的 2 0 8%和 2 4 5 % ,差异有显著性 (P <0 0 5 )。研究组NST异常者新生儿预后不良的发生率为 6 4 8% ,NST正常者新生儿预后不良的发生率为 17 7% ,两者比较 ,差异有显著性 (P<0 0 5 )。研究组行剖宫产和NST异常行剖宫产者的新生儿预后不良发生率分别为 75 9%和 71 7% ,与对照组 (75 0 %和 6 0 6 % )比较 ,差异均无显著性 (P >0 0 5 )。结论　应用远程胎儿监护网络进行高危妊娠的监测 ,可减少新生儿窒息和早产的发生 ,而对剖宫产率无影响 ,为高危妊娠的自我监护提供了一种可靠的新手段

Clinical value of remote fetal monitoring network in high-risk pregnancy

OBJECTIVE: To investigate the clinical value of remote fetal monitoring network in high-risk pregnancy. METHODS: Non-stress test (NST) was carried on in 116 high-risk gravida by remote fetal monitoring network (study group). One hundred high-risk pregnant women served as control group, were monitored by fetal movement counting daily and regular NST check-up in hospital. Results of fetal monitoring, neonatal prognosis and cesarean section were analyzed between the study and control group. RESULTS: NST was applied more frequently in the study group (9.2 +/- 4.9) times than in control group (2.6 +/- 1.3) times (P < 0.001). But the costs were similar. The incidences of neonatal asphyxia (10.3%) and preterm birth (12.6%) in the study group were lower than those in the control group (20.8% and 24.5%) (P < 0.05). In the study group, there was significant difference in the rate of poor neonatal prognosis between normal and abnormal NST groups (64.8% and 17.7%) (P < 0.05). There was no significant difference in the rates of cesarean section (75.9% and 75.0%, respectively) and poor neonatal prognosis of cesarean section with abnormal NST (71.7% and 60.6%, respectively) between the study and control groups (P > 0.05). CONCLUSIONS: Remote fetal monitoring network can be used to improve the quality of fetal monitoring, especially in primary hospital. It decreased the rate of neonatal asphyxia and preterm delivery but didn't increase the cesarean section rate. It offers a reliable and economic method of self-monitoring for high-risk pregnant women.