论文部分内容阅读
目的探讨小于胎龄早产儿胎心电子监护图形(CTG)特征及其临床意义。方法回顾性分析303例32~36孕周、无妊娠合并症的单纯胎膜早破和原因不明早产孕妇的全产程CTG。其中,小于胎龄早产儿78例(PSGA组),适于胎龄早产儿225例(PAGA组)。比较宫缩时两组CTG特征,合并症情况及分娩结局。结果PSGA组及PAGA组出现单纯U型变异减速的胎儿分别为24例(308%)和10例(44%),两组比较,差异有统计学意义(P<001);U型变异减速合并其他异常CTG的胎儿分别为10例(128%)和1例(04%),两组比较,差异也有统计学意义(P<001)。PSGA组,出现单纯U型变异减速者的难产率(208%)与胎心电子监护无异常者的难产率(227%)比较,差异无统计学意义(P>005),但与U型变异减速合并其他异常CTG者的难产率(600%)比较,差异有统计学意义(P<005)。PSGA组中,34例出现U形变异减速,其中合并脐带异常15例(绕颈、绕身14例、脐带过短1例),PSGA组44例无U形变异减速者中,合并脐带异常9例(绕颈、绕身),两组比较,差异有统计学意义(P<005)。结论U形变异减速是小于胎龄早产儿分娩过程中的特征性胎儿监护图形,但不是胎儿缺氧的征象,如不合并其他异常CTG,不需特殊处理。
Objective To investigate the characteristics of fetal heart rate monitor (CTG) in preterm infants with small gestational age and its clinical significance. Methods Retrospective analysis of 303 cases of 32 to 36 gestational weeks, no pregnancy complications of simple premature rupture of membranes and unexplained preterm pregnant women full-term CTG. Among them, 78 cases of preterm infants less than gestational age (PSGA group), suitable for gestational age 225 cases of premature children (PAGA group). To compare contractility CTG characteristics of two groups, complications and delivery outcomes. Results There were 24 cases (308%) and 10 cases (44%) in the PSGA group and the PAGA group, respectively. The differences between the two groups were statistically significant (P <001) Other fetuses with abnormal CTG were 10 (128%) and 1 (04%) fetuses, respectively. There was also a significant difference between the two groups (P <0.001). In the PSGA group, there was no significant difference in the rate of dystocia (208%) in those with simple U-shaped deceleration compared with 227% in those without abnormal fetal heart rate monitoring (P> 005) The rate of dystocia (600%) in deceleration combined with other abnormal CTGs was significantly different (P <005). PSGA group, 34 cases of U-shaped degeneration, including the abnormal umbilical cord in 15 cases (around the neck, around 14 cases, the umbilical cord was too short in 1 case), PSGA group of 44 patients without U-shaped degeneration, with umbilical cord abnormalities 9 Cases (around the neck, around the body), the two groups, the difference was statistically significant (P <005). Conclusions U-shaped degeneration is a characteristic fetal monitoring pattern during childbirth in gestational-age preterm infants, but it is not a sign of fetal hypoxia. Without additional abnormal CTG, no special treatment is required.