摘要
目的探讨高危妊娠应用胎儿脐血流监测及胎心监护监测的预测价值。方法回顾性分析2021年3月—2023年3月中国人民解放军空军特色医学中心妇产科收治的180例高危妊娠孕妇的临床资料,均开展胎儿脐血流监测和胎心监护监测。根据产前脐血流和胎心的监测结果,将研究对象分为甲组、乙组、丙组、丁组4组。对比4组的分娩指标(剖宫产、胎儿窘迫、脐带缠绕、羊水过少、胎粪污染、新生儿出生1 min内阿氏评分)、脐血流指标[脐动脉血流比值(systolic to diastolic velocity ratio,S/D)、脐动脉阻力指数(resistance index,RI)、脐动脉搏动指数(pulsatility index,PI)]。结果丁组剖宫产(79.17%)、胎儿窘迫(50.00%)、脐带缠绕(50.00%)、羊水过少(70.83%)、胎粪污染(100.00%)的不良分娩情况发生率最高,显著高于甲组、乙组,差异有统计学意义(P<0.05)。甲组新生儿出生1 min内阿氏评分8~10分比例显著高于乙组、丙组、丁组(P<0.05)。乙组和丙组新生儿出生1 min内阿氏评分8~10分比例均高于丁组(P<0.05)。丁组脐动脉血流指标(S/D值、RI、PI)高于甲组、乙组、丙组,差异有统计学意义(P<0.05)。结论对高危妊娠孕妇应用胎儿脐血流监测及胎心监护监测,可对不良妊娠结局提高预测准确性,有助于围产期的治疗与管理,减少不良分娩结局的产生,提高分娩质量。
Objective To explore the predictive value of fetal umbilical blood flow monitoring and fetal heart rate monitoring in high-risk pregnancy.Methods From March 2021 to March 2023,the clinical data of 180 high-risk pregnant women admitted to the department of obstetrics and gynecology,Air Force Medical Center,PLA were retrospectively analyzed.All the eligible subjects were monitored by fetal umbilical blood flow and fetal heart rate.According to the results,the subjects were divided into four groups:Group A,Group B,Group C and Group D.The childbirth indicators of the research subjects(cesarean section,fetal distress,umbilical cord entanglement,oligohydramnios,meconium contamination,Apgar score within 1 minute after birth);umbilical blood flow indicators[umbilical artery blood flow S/D value,umbilical artery vascular resistance index(RI),umbilical artery pulsation index(PI)]were compered.Results The incidence of adverse delivery in group D was the highest in cesarean section(79.17%),fetal distress(50.00%),umbilical cord entanglement(50.00%),oligohydramnios(70.83%),and meconium contamination(100.00%),which was significantly higher than that in group A and group B(P<0.05).The Apgar score of 8-10 within 1 minute after birth in Group A was higher than that in Group B,C,D(P<0.05).The Apgar score of 8-10 points within 1 minute of birth of newborns in Group B and C was higher than that of group D(P<0.05).The umbilical artery blood flow index(S/D,RI,PI)in Group D was higher than that in Group A,B,C,the difference was statistically significant(all P<0.05).Conclusion The application of fetal umbilical blood flow monitoring and fetal heart rate monitoring in high risk pregnant women can improve the accuracy of prediction of adverse pregnancy outcomes.It is helpful to the treatment and management of perinatal period,and reduce the occurrence of adverse delivery outcomes,improve the quality of delivery.
作者
刘晓莉
陈建昆
LIU Xiaoli;CHEN Jiankun(Department of Obstetrics,Gynecology and Reproductive Medicine,Air Force Medical Center,PLA,Beijing 100142,China)
出处
《中国卫生标准管理》
2024年第7期29-32,共4页
China Health Standard Management
关键词
高危妊娠
胎儿脐血流
脐动脉
胎心监护
预测
分娩结局
high-risk pregnancy
fetal cord blood flow
umbilical artery
fetal heart rate monitoring
prediction
delivery outcome
