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目的:探讨监测孕早期胎心率(fetal heartrate,FHR)对胎儿生存预后的预测价值,尤其对已有流产征兆或有重复、习惯性流产史患者的胎儿不良生存结局的预测价值。方法:收集自2003到2007年至我院门诊要求生育的正常早孕孕妇以及有先兆流产征象或重复、习惯性流产病史、孕周在5-9+6周要求生育的孕妇415例。采用超声测定孕囊(gestational sac,GS)平均直径、胚胎头臀径(crown-rump length,CRL)、FHR。如果胎儿存活,则在孕中期11-14周时测量胎儿颈项皮肤层厚度(nuchal translucency,NT)。采用X检验分析孕早期胎心率与胎儿存活率及NT值的关系。结果:胎心率低时,胎儿存活率降低(P<0.05),NT值异常升高发生率增多(P<0.05)。结论:孕早期胎心率测定对预测胎儿生存预后有一定的临床意义,并且胎心率减慢还与孕中期NT值异常升高相关,因此,孕早期胎心率可作为筛查和预测中晚期妊娠胎儿畸形的重点监测对象。
Objective: To investigate the predictive value of fetal heart rate (FHR) in predicting fetal survival prognosis in early pregnancy, especially for predicting unfavorable fetal survival in patients with abortion symptoms or with repeated and habitual abortion. METHODS: A total of 415 pregnant women with normal early pregnancy expecting fertility and having threatened abortion or having recurrent spontaneous abortion history from 2003 to 2007 were enrolled in our hospital. There were 415 pregnant women who required fertility during 5-9 + 6 weeks gestation. The mean diameter of gestational sac (GS), crown-rump length (CRL) and FHR were measured by ultrasound. If the fetus survives, fetal neck skin thickness (nuchal translucency, NT) is measured at 11-14 weeks of gestation. X-test was used to analyze the relationship between fetal heart rate and fetal survival rate and NT value in early pregnancy. Results: Fetal heart rate was lower (P <0.05), and abnormal increase of NT value was found (P <0.05). Conclusion: Fetal heart rate measurement in early pregnancy has some clinical significance in predicting the prognosis of fetal survival, and the decrease of fetal heart rate is related to the abnormal NT value in the second trimester. Therefore, fetal heart rate in early pregnancy can be used as a screening and prediction Late pregnancy abnormal fetal focus monitoring object.