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产时采用胎心电子外监护824例,出现异常监护图240例,占29.1％,其中胎心基线率异常46例,基线变异异常64例,胎心率各种减速130例。潜伏期80例,占22％(80/360),活跃期112例占35％(112/320),二产程48例,占46％(48/104)。胎心基线率异常的新生儿窒息率4％(2/46),基线变异异常的新生儿窒息率19％(12/64),胎心率各种减速的新生儿窒息率6％(8/130)。基线变异异常组中,新生儿窒息率明显高于其它两组,P<0.05,有显著差异。分析表明:潜伏期出现晚减,基线变异异常,重度可变减都是胎儿宫内缺氧的信号;活跃期及二程出现重度可变减预示严重脐带并发症;晚减合并基线变异异常表示胎盘储备功能不良。随着产程的进展,异常胎心监护图逐渐增加,重度可变减首先考虑脐带因素,晚减伴基线变异异常提示胎儿宫内严重缺氧,需尽快终止妊娠。
There were 824 cases of fetus heart outside the guardianship during delivery, 240 cases of abnormal guardianship, accounting for 29.1%, including 46 cases of abnormal baseline fetal heart rate, abnormal baseline changes in 64 cases, 130 cases of various fetal heart rate deceleration. Incubation period was 80 cases, accounting for 22% (80/360), active stage 112 cases accounted for 35% (112/320), and the second stage 48 cases, accounting for 46% (48/104). 4% (2/46) newborns with abnormal baseline fetal heart rate, 19% (12/64) newborns with abnormal baseline abnormalities, and 6% (8% 130). Abnormal baseline changes in neonatal asphyxia was significantly higher than the other two groups, P <0.05, significant differences. The analysis showed that there were late hypoxia, abnormal baseline variation and severe variable hypothyroidism, all of which were the signals of intrauterine hypoxia. Severe changes in the active stage and the second course showed severe umbilical cord complications. Late hypothyroidism and abnormal baseline changes indicated the placenta Poor reserve function. With the progress of labor, abnormal fetal heart rate monitoring chart gradually increased, the first variable to consider the umbilical cord variable heavy reduction with baseline abnormalities prompt abnormal fetal hypoxia, termination of pregnancy as soon as possible.