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[目的]研究探讨产时胎心监护异常的作用及临床意义。[方法]回顾性分析某院近3年来563例单胎头位分娩时使用产科胎心监护系统进行产时胎心监护的资料,研究其与新生儿预后的关系。[结果]胎心监护评分8～10分组(正常组)388例,评分5～7分(可疑组)123例,评分1.4分(异常组)52例;其中异常组羊水胎粪污染率、新生儿Apgar评分≤7分者的比例、新生儿疾病的比例均高于正常组(P﹤0.01);异常羊水Ⅲ度污染率、新生儿Apgar评分≤7分者的比例高于可疑组,差异有统计学意义。胎心率异常的发生率为53%(195/368).出现基线变异减弱、重度变异减速、晚期减速、延长减速图形者新生儿窒息发生率高,差异有统计学意义(P﹤0.01)。[结论]产程中使用产科胎心监护系统进行胎心监护,如评分≤7,或出现异常胎监图形均应予重视,应及时了解羊水性状,以及早发现胎儿窘迫及时处理,减少新生儿窒息率、发病率,提高出生人口质量。
[Objective] To investigate the effect and clinical significance of abnormal fetal heart rate monitoring during labor. [Methods] The data of 563 cases of single fetus with single fetal head during childbirth in a hospital during the past 3 years were retrospectively analyzed. The relationship between the delivery time and the prognosis of newborns was studied. [Results] There were 388 cases with fetal heart rate monitoring score of 8 to 10 (normal group), 123 with score of 5 to 7 (suspicious group) and 52 with score of 1.4 (abnormal group). Among the abnormal group, The proportion of children with Apgar score less than or equal to 7 was higher than that of normal group (P <0.01). The rate of Ⅲ degree abnormal amniotic fluid contamination and neonatal Apgar score ≤7 was higher than that of suspicious group Statistical significance. The incidence of fetal heart rate abnormalities was 53% (195/368) .There was a significant difference in the incidence of neonatal asphyxia between baseline degenerative changes, severe degenerative decelerations, late decelerations and extended decelerations (P <0.01). [Conclusion] Obstetric fetal heart monitoring system for fetal heart rate monitoring in labor should be paid attention to. For example, if the score is less than or equal to 7 or abnormal fetal monitor patterns should be taken seriously, the amniotic fluid trait should be understood in time and early detection of fetal distress should be treated promptly to reduce neonatal asphyxia Rate, incidence, improve the quality of birth population.