早产产时连续胎儿电子监护的临床意义

目的:研究胎儿电子监护(EFM)对无妊娠合并症早产产时连续监护的临床意义。方法:对2002年1月~2003年5月分娩的32~36孕周无妊娠合并症的单纯胎膜早破和原因不明早产169例(研究组)进行产时全程胎儿电子监护,并与1999年1月~2000年5月分娩的未行EFM的32~36孕周的难免早产188例(对照组)进行比较,分析两组胎儿窘迫发生率、新生儿窒息率、脐动脉血气分析结果和胎儿窘迫因素手术产率。结果:使用EFM后研究组胎心异常检出率较对照组显著升高;研究组胎儿酸中毒率、新生儿窒息率明显低于对照组;两组胎儿宫内窘迫原因的手术产率和羊水粪染率无显著差异。在研究组,监护异常的70例产妇分娩低体重儿和小于孕龄儿的发生率较99例正常胎监结果组明显升高。结论:产时全程胎儿电子监护是一种对早产行之有效的分娩管理手段,它的使用有利于胎儿早期缺氧的及时发现和治疗,从而使早产新生儿窒息率和酸中毒率明显下降。

Clinical Analysis of Continuous Electronic Fetal Heart Rate Monitoring of Preterm Pregancy During Labor

Objective:To investigate the clinical value of the continuous electronic fetal heart rate monitoring for non-high risk pregnancy during labor.Methods:169 non-high risk pregnant patients between 32 weeks and 36 weeks of gestation,who got inevitable preterm labor because of premature rupture of membrane or unknown causes,assigned as the study group,were performed continuous electronic FHR monitoring during labor from January 2002 to May 2003.A total of 188 patients of inevitable preterm labor assigned as the control group were not performed electronic FHR monitoring during labor from January 1999 to May 2000.The rate of fetal distress,neonatal asphyxia,umbilical blood gas and operative labor because of fetal distress in the two groups were compared.Results:The incidence of abnormal FHR was significantly higher in the study group than in the control group(respectively 41.42% vs 30.31%,P<0.05);The incidence of neonatal asphyxia was significantly lower in the study group than in the control group(respectively 2.37% vs 7.98%,P<0.05);The acidosis rate of umbilical blood was significantly lower in the study group than in the control group(respectively 4.14% vs 10.65%,P<0.05).The operative rate of fetal distress and meconium stained amniotic fluid rate were not different between the two group(P>0.05).In the study group,compare to the normal EFM result group,the incidence of low birth weight significantly higher in the abnormal EFM result group(respectively 35.71% vs 6.06%,P<0.01).Conclusion:The study suggested that the continuous electronic FHR monitoring was an effective labor managing method also for preterm pregency.The application of this method could make early-stage fetal hypoxia detected and cured timely,decrease the rate of preterm neonatal asphyxia and acidosis significantly.