摘要
目的探讨发生于不同产程时段胎儿窘迫的临床相关因素及围产结局。方法总结239例诊断胎儿窘迫的临床资料,根据孕妇所处的不同产程分为产前组、潜伏期组、活跃期组及第二产程组,并根据其临床表现不同分为4种诊断标准。分析四组各不同诊断标准的胎儿窘迫发生率及相关临床高危因素和围产结局。结果第二产程组发生胎儿窘迫率最高。四种诊断标准中,以单纯羊水Ⅲ度粪染为其诊断标准的胎儿窘迫发生率,产前组及潜伏期组高于其他两组。以羊水Ⅲ度粪染同时合并胎心率异常变化为其诊断标准的胎儿窘迫发生率,活跃期组明显高于其他三组。四组之间比较有显著性差异(P<0.05)。各组所具高危因素均以脐带异常为其主要因素。结论胎儿窘迫可发生在各产程时段,而以第二产程中发生率最高。发生胎儿窘迫距胎儿娩出的时间与新生儿预后密切相关。羊水污染可视为发生慢性胎儿宫内窘迫的预警指标,而羊水污染合并胎心异常则高度提示已存在胎儿宫内缺氧。如何及时、准确判断胎儿窘迫的发生及正确处理是提高围产期质量的重要环节。
Objective To discuss the obsterics factors and perinatal consequence of fetal distress in different stage of labor. Methods 239 cases of fetal distress were reviewed. They were classified into 4 groups： antenatal group, latent period group, active phase group and expulsive stage group. Diagnostic criteria was made according to different clinical signs. Results The morbid rate of fetal distress in the expulsive stage group was the highest among the four sets of diagnostic criteria, Conclusions Fetal distress may occur in every stage of labor. Amniotic fluid contamination can be regarded as the early warning indicator of chronic fetal distress. Amniotic fluid contamination complicated with fetal heart abnormality suggests the presence of fetal distress. The diagnosis of the fetal distress promply is critical,
出处
《北京医学》
CAS
2005年第11期650-652,共3页
Beijing Medical Journal
