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目的探讨无应激试验低评分的相关因素及临床意义,寻求最佳分娩方式。方法用电子胎儿监护仪对1431例孕妇进行无应激试验(NST),对其中129例NST≤9分者按正常妊娠和高危妊娠分两组进行分析。结果高危妊娠组胎心基线率变异消失或减弱为74.3%,剖宫产率占91.4%,羊水粪染率占71.4%,新生儿窒息率占28.6%,有2例围产儿死亡;正常妊娠组相对应数据分别为24.5%、55.3%、19.1%、2.1%,无围产儿死亡病例。两组比较差异有显著性(P<0.01)。分析两组相关因素,高危妊娠组中羊水过少,妊娠期肝内胆汁淤积症、妊娠期高血压疾病及胎儿生长受限等病症占有一定比例;而正常妊娠组产后发现明显原因致NST低评分系脐带因素的有28例(29.8%),无明显原因者占67.0%。结论高危妊娠NST低评分者应引起高度重视,适时终止妊娠,降低围产儿病死率;正常妊娠NST低评分者可行OCT、生物物理评分等进一步监测,选择适当分娩方式。
Objective To investigate the related factors and clinical significance of low-stress test without stress and to find out the best mode of delivery. Methods 1431 pregnant women under non-stress test (NST) were studied by electronic fetal monitor. 129 cases with NST≤9 were divided into normal pregnancy and high risk pregnancy. Results The rate of baseline fetal heart rate variability disappeared or weakened to 74.3% in high-risk pregnancy group, cesarean section rate was 91.4%, amniotic fluid meconium rate was 71.4%, neonatal asphyxia rate was 28.6%, and 2 cases of perinatal death; normal pregnancy group The corresponding data were 24.5%, 55.3%, 19.1% and 2.1%, respectively. There were no cases of perinatal deaths. There was significant difference between the two groups (P <0.01). Analysis of two groups of related factors, high-risk pregnancy group, oligohydramnios, intrahepatic cholestasis of pregnancy, gestational hypertension and fetal growth restriction and other diseases accounted for a certain proportion; normal pregnancy group postpartum were found to cause obvious reasons for NST low score Department of umbilical cord factors in 28 cases (29.8%), no obvious reason accounted for 67.0%. Conclusion NST low-rated high-risk pregnancy should be given high priority, timely termination of pregnancy, reduce the perinatal mortality; normal pregnancy NST low score OCT may be feasible, biophysical score further monitoring, select the appropriate mode of delivery.