摘要
目的:探讨第二产程胎心监护对胎儿酸血症的预测价值,CTG图形与胎儿酸血症类型的关系,异常CTG图形胎儿娩出时限与低Apgar评分及新生儿缺氧缺血性脑病的关系。方法:对216例足月、单胎、头位、无阴道分娩禁忌症者第二产程连续电子胎心监护,胎儿娩出后留脐动脉血做血气分析,Apgar评分,并追踪新生儿是否发生缺氧缺血性脑病。结果:第二产程连续胎心监护CTG图形正常型对胎儿酸血症的阳性预测值1.23%,可疑型阳性预测值4.00%,异常型阳性预测值40.00%,CTG图形正常型和可疑型,胎儿酸血症类型为呼吸性酸血症,异常型胎儿酸血症类型为呼吸性酸血症、混合性酸血症、代谢性酸血症。新生儿窒息发生在混合性酸血症及代谢性酸血症组,呼吸性酸血症组无新生儿窒息。异常CTG图形胎儿娩出时限与低Apgar评分、新生儿缺氧缺血性脑病有关。结论:第二产程出现异常CTG图形对胎儿酸血症有预测价值,混合性酸血症及代谢性酸血症对新生儿结局影响较大。出现异常CTG图形后胎儿娩出时限与新生儿缺氧缺血性脑病有关,但出现异常CTG图形后应在多长时限内结束分娩能避免新生儿缺氧缺血性脑病的发生,尚需更多的病例观察。
Objective： To determine the predictive value of FHR monitoring for fetal acidemia during the second stage of labor, the relationship between FHR patterns and different types of fetal acidemia and the relationship between the duration from pathological FHR patterns to delivery and low Apgar score and neonatal hypoxiaischemic encephalopathy. Methods： 216 cases with singleton, term pregnancy, without contraindications for vaginal delivery were carried out continuous electronic fetal heart rate monitoring （EFM） during the second stage of labor Umbilical blood gas was analyzed at birth, Apgar score was recorded and neonatal hypoxia - ischemic encephalopathy was followed up. Results： The positive predictive value of normal, suspicious and pathological FHR patterns for predicting fetal acidemiain the second stage was 1.23% , 4. 00% and 40. 00%. When the FHR patterns was normal and suspicious, the type of fetal acidemia was respiratory and when pathological, the types were respiratory, mixed and metabolic one. Neonatal asphyxia was recorded in mixed and metabolic acidemia group and no asphyxia in respiratory acidemia one. The duration from pathological FHR patterns to delivery, were associated with low Apgar score and neonatal hypoxia - ischemic encephalopathy. Conclusion： The pathological FHR patterns during the second stage of labor have predictive value for fetal academia and the mixed and metabolic academia have more greatly effect on neonatal outcome than the respiratory one. The duration from pathological FHR patterns to delivery are associated with neonatal hypoxia - ischemie encephalopathy. But the duration from pathological FHR patterns to delivery need more cases to study in avoiding neonatal hypoxia -ischemic encephalopathy
出处
《中国妇幼保健》
CAS
北大核心
2006年第2期165-167,共3页
Maternal and Child Health Care of China
关键词
第二产程
胎儿心率
酸血症
缺氧缺血性脑病
Second stage of labor
Fetal heart rate
Acidemia
Hypoxia - isehemie eneephalopathy
