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目的探讨脐血流测定联合胎心监护预测围产儿结局的临床意义。方法按脐血流测定及胎心监护结果,将280例住院单胎孕妇分为四组,A组224例为脐血流测定与胎心监护均正常;B组21例为脐血流测定正常,胎心监护异常;C组20例为脐血流测定异常,胎心监护正常;D组15例为脐血流测定与胎心监护均异常。对四组羊水污染、新生儿窒息和围产儿死亡情况进行比较分析。结果 D组不良结局总发生率(羊水污染、新生儿窒息及围产儿死亡)高于其他三组(P<0.01)。B组、C组不良结局总发生率均高于A组(P均<0.01),B组、C组之间比较无统计学差异(P>0.05)。A组、B组、C组均无围产儿死亡,D组1例因羊水Ⅲ度污染,重度窒息死亡。结论脐血流测定联合胎心监护能及时发现胎儿宫内缺氧,可指导临床积极处理异常,对降低新生儿窒息率、围产儿死亡率具有重要意义。
Objective To investigate the clinical significance of umbilical cord blood flow measurement combined with fetal heart rate monitoring in predicting perinatal outcome. Methods According to the umbilical cord blood flow measurement and fetal heart rate monitoring results, 280 hospitalized singleton pregnant women were divided into four groups, 224 cases in group A were normal umbilical cord blood flow measurement and fetal heart monitoring; 21 cases in group B were normal umbilical blood flow , Fetal heart monitoring abnormalities; C group of 20 cases of umbilical cord blood flow abnormalities, normal fetal guardianship; D group 15 cases of umbilical cord blood flow measurement and fetal heart monitoring are abnormal. Four groups of amniotic fluid contamination, neonatal asphyxia and perinatal mortality were compared. Results The total incidence of adverse outcomes in group D (amniotic fluid contamination, neonatal asphyxia and perinatal death) was higher than the other three groups (P <0.01). The overall incidence of adverse outcomes in group B and group C were higher than those in group A (P <0.01). There was no significant difference between group B and C (P> 0.05). No deaths occurred in group A, B and C, and in group D 1 died of severe degree suffocation due to amniotic fluid Ⅲ degree pollution. Conclusion Umbilical cord blood flow monitoring combined with fetal heart rate monitoring can detect fetal intrauterine hypoxia in time, which can guide the clinical treatment of abnormalities. It is of great significance to reduce neonatal asphyxia and perinatal mortality.