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目的探讨新生儿窒息与羊水粪染和胎心监护的相关性。方法对2002年10月至2004年10月142例住院新生儿窒息患儿的羊水性质、胎心监护等进行整理分析。结果新生儿窒息与羊水粪染有关,羊水粪染者的新生儿窒息发生率显著高于羊水清亮者(P<0.01),羊水Ⅲ度粪染的新生儿窒息率明显高于羊水轻度粪染及无羊水粪染者(P<0.01);羊水粪染的胎心监护异常发生率显著高于羊水清亮组(P<0.05);胎心监护对新生儿窒息的阳性预测率为34.51%。结论新生儿窒息的发生与羊水粪染的程度密切相关,羊水粪染的程度越重,新生儿窒息率越高,胎心监护可及时发现胎儿宫内窘迫,胎心监护异常与羊水粪染有关,对羊水Ⅲ度粪染应立即结束分娩,出现Ι、Ⅱ度羊水粪染时必须在胎心监护下密切观察产程进展,一旦出现异常尽快结束分娩,以降低新生儿窒息的发生率和死亡率。
Objective To investigate the correlation between neonatal asphyxia and amniotic fluid meconium staining and fetal heart rate monitoring. Methods From October 2002 to October 2004 142 cases of hospitalized neonates with amniotic fluid amniotic fluid properties, fetal heart rate monitoring were analyzed. Results Neonatal asphyxia was associated with meconium-stained amniotic fluid. The incidence of neonatal asphyxiation was significantly higher in amniotic fluid-stained women than in amniotic fluid-clear (P <0.01). Neonatal asphyxia in meconium-stained amniotic fluid Ⅲ was significantly higher than mild meconium-stained amniotic fluid (P <0.01). The incidence of anomalous fetal heart monitoring was significantly higher than that of amniotic fluid clear group (P <0.05). The positive predictive rate of fetal heart rate monitoring for neonatal asphyxia was 34.51%. Conclusions Neonatal asphyxia is closely related to the degree of meconium-stained amniotic fluid. The more meconium-stained amniotic fluid is, the higher the neonatal asphyxia rate is. Fetal heart monitoring can detect fetal distress in time and the abnormal fetal heart rate monitoring is related to meconium-stained amniotic fluid , Ⅲ degrees of amniotic fluid feces should immediately end of childbirth, ⅰ, Ⅱ degree amniotic meconium must be under fetal heart rate monitoring of labor progress closely observed in the event of abnormal delivery as soon as possible to reduce the incidence of neonatal asphyxia and mortality .