胎心人室试验联合人工破膜预测分娩及胎儿结局临床研究

目的 探讨胎心入室试验联合人工破膜对预测胎儿宫内窘迫的价值. 方法 将2008年6月至2009年6月人我院后24 h内分娩的1316例孕妇（33^＋5～43孕周）根据胎心入室试验分为低风险组和高风险组,分析其胎心入室试验、分娩结局、羊水及新生儿Apgar评分. 结果 胎心入室试验示1030例为反应型（78.27%）,144例为可疑型（10.94%）,142例为危险型（10.79%）;总的新生儿窒息率为6.53%（86例）,反应型组窒息率为1.94%（20例）,危险型为33.33%（48例）;羊水污染率反应型为20.97%（216例）,危险组为67.61%（96例）,2组间差异有统计学意义（P＜0.01）.高危孕妇可疑型、危险型的羊水污染率及新生儿窒息率均较低风险孕妇高,两组间差异有统计学意义（P＜0.05）. 结论 胎心入室试验反应型可预测在以后的4～5 h内胎儿在宫内是安全的,胎心入室试验联合人工破膜可预测胎儿预后.

Clinical research on predicting fetal distress in labor by admission test of fetal heart rate and artificial rupture of membrane

Objective To evaluate the value of admission test of fetal heart rate and artificial rupture of membrane in predicting fetal distress in labor. Methods Totally 1316 pregnant women who had been pregnant for 33 + 5 to 43 weeks and deliveried spontaneously in 24 hours were divided into low risk group and hign risk group,according to the admission tests.The admission test,result of delivery,amniotic fluid contamination and Apgar scores of newborns were analyzed. Results All 1030 cases were reactive type(78.72%),144 cases were equivocal type(10.94%)and 7142 cases were ominous type(10.79%).Total incidence of neonatal asphyxia was 6.53%.It was 1.94% ,12.50% and 33.33% in reactive type subjects,equivocal type subjects and ominous type subjects,respectively.The incidences of amniotic fluid contamination and neonatal asphyxia were lower significantly in the low risk group than those in the high-risk group and equivocal type group(P ＜ 0.05). Conclusion Admission test of fetal heart rate and artificial rupture of membrane can be used to screen fetal distress in labor.