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目的 探讨远程胎儿监护网络在妊娠肝内胆汁瘀积症 (intrahepatic cholestasis of preg-nancy,ICP)产前监测的临床价值。 方法 采用远程胎儿监护网络 ,对 5 4例 ICP孕妇进行产前无负荷试验 (NST)监测 (研究组 ) ,同期进行常规胎儿监护 (胎动计数和定期到医院进行 NST检查 )的 ICP孕妇 5 4例作为对照 (对照组 ) ,分析两组胎儿监护结果和围产儿结局。 结果 研究组 NST异常检出率 (36 .1% )较对照组 (2 7.2 % )明显增加 (P<0 .0 5 )。研究组 NST异常图形为变异减速、基线变异减少或消失和胎儿心率 (fetal heart rate,FHR)过缓的百分率分别为 4 4 .1%、13.8%和 9.2 % ,与对照组(分别为 2 1.3%、2 9.8%和 2 3.4 % )比较 ,差异均有显著性 (P<0 .0 5 )。研究组新生儿窒息和早产儿的发生率分别为 11.1%和 9.3% ,低于对照组的 2 7.8%和 2 4 .1% (P<0 .0 5 )。两组剖宫产率的差异无显著性 (P>0 .0 5 )。 结论 利用远程胎儿监护网络进行 ICP产前监测 ,可改善围产儿预后 ,是 ICP孕妇自我监护的新选择。
Objective To investigate the clinical value of remote fetal monitoring network in prenatal monitoring of intrahepatic cholestasis of preg-nancy (ICP). Methods Fifty-four pregnant women with ICP were enrolled in this study. Fifty-four pregnant women with ICP were enrolled in the study. Prenatal no-load testing (NST) was performed in 54 pregnant women with ICP, and 44 pregnant women undergoing routine fetal monitoring (fetal movement count and NST inspection regularly) As a control (control group), two groups of fetal guardianship outcomes and perinatal outcomes were analyzed. Results The detection rate of abnormal NST in study group (36.1%) was significantly higher than that in control group (7.2%) (P <0.05). In the study group, the abnormal patterns of NST were decelerated by deceleration, the reduction or disappearance of baseline variance and the percentage of bradycardia (FHR) bradycardia were 44.1%, 13.8% and 9.2%, respectively, which were significantly lower than those in the control group %, 2 9.8% and 23.4%), the difference was significant (P <0.05). The incidence of neonatal asphyxia and premature babies in the study group was 11.1% and 9.3%, respectively, which was lower than 7.8% and 2.4% (P <0.05) of the control group. There was no significant difference in cesarean section rate between the two groups (P> 0.05). Conclusions ICP prenatal monitoring using a remote fetal monitoring network can improve the prognosis of perinatal infants and is a new option for the self-monitoring of ICP pregnant women.