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目的回顾性分析854例胎儿窘迫患者术前检查及剖宫产术所见,提高胎儿窘迫的诊断水平。方法提出胎儿窘迫病例的筛选标准,并于剖宫产所见进行分析,探讨以上标准的符合性及临床意义。结果854例胎儿窘迫20.03%发生在产前,79.97%发生在产程中,其中58.20%发生在第一产程末及第二产程。所有病例均出现不同程度的胎心监护图异常。83.37%在产程中出现羊水Ⅱ°以上污染,68.51%的孕妇有各种高危因素。经剖宫产证实脐带异常者39.82%,胎盘因素9.95%,羊水过少者38.05%。胎儿窘迫中35.58%发生新生儿窒息。结论1.要做到对胎儿窘迫的早期诊断,必须加强对高危孕妇的筛查及系统管理,同时要提高胎儿胎盘功能监测的水平。2.临床胎心监护是对胎儿窘迫筛查重要指标。3.产程中羊水Ⅱ°以上污染或进行性加重与胎儿缺氧有密切关系。
Objective To retrospectively analyze the preoperative diagnosis and cesarean section in 854 cases of fetal distress, and to improve the diagnosis of fetal distress. Methods Fetal distress cases screening criteria, and seen in cesarean section analysis, to explore the compliance of the above criteria and clinical significance. Results 854 cases of fetal distress 20.03% occurred in the prenatal period, 79.97% occurred in the labor process, of which 58.20% occurred at the end of the first stage of labor and the second stage of labor. All cases showed different degrees of fetal heart rate monitor abnormalities. 83.37% amniotic fluid Ⅱ ° in the labor appears more than pollution, 68.51% of pregnant women have various risk factors. 39.82% of umbilical cord abnormalities confirmed by cesarean section, 9.95% of placental factors, 38.05% of oligohydramnios. 35.58% of fetal distress occurred in neonatal asphyxia. Conclusion 1. To achieve early diagnosis of fetal distress, screening and systematic management of high-risk pregnant women must be strengthened, meanwhile, to improve the level of fetal placental function monitoring. 2. Clinical fetal heart rate monitoring is an important indicator of fetal distress screening. 3 labor in amniotic fluid Ⅱ ° or more pollution or progressive increase in fetal hypoxia are closely related.