产时不同类型胎儿酸血症与胎心监护图形的关系

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1、产时不同类型胎儿酸血症与胎心监护图形的关系中华妇产科杂志1998年第8期第0卷论著作者：吴连方　Thorngren-JerneckK　IngemassonI单位：100006北京妇产医院(吴连方)；LUNDUniversityHospital(Thorngren-JerneckK,IngemassonI)关键词：酸中毒；心率；胎儿；心分娩力描记法　　　　【摘要】　目的　研究产时脐动脉血显示的不同类型酸血症与产时胎心监护图形变化的关系及产后4年随诊的结果。方法　采用回顾性病例对照研究方法，选择对象

2、为1991年单胎、足月分娩的2981例新生儿，产程中定时胎心监护，分娩时测定脐动脉血气。生后4年进行儿童随诊。结果　纯代谢性酸血症47例(代酸组)，混合性酸血症67例(混酸组)，该两组在第一产程末，胎心率评分＜6和6～7分者发生率显著高于对照组。减速图形特点显示晚期减速与纯代谢性酸血症有关，而异常可变减速与混合性酸血症有关。两组产后1分钟Apgar评分＜7分者也明显高于对照组。儿童4岁时随诊其发育、运动和语言能力显示：代酸组及混酸组和对照组比较差异无显著性，只在混酸组语言表达迟钝的例数略多。结论

3、　晚期减速可能是纯代谢性酸血症的一个表现，而异常可变减速可能是混合性酸血症的一个表现。两者均与1分钟Apgar评分低分的发生有密切关系。产时酸血症和以后的语言发育缺陷间关系需进一步估价。　　DifferentTypesofAcidemiaatBirth,FetalHeartRatePatternsandInfantsOutcomeatfourYearsofAge　WuLianfang,Thorngren-JerneckK,IngemassonI.　BeijingObstetricandGynec

4、ologyHospital,Beijing100006　　【Abstract】　Objective　Tostudytherelationsbetweendifferenttypesofacidemiainumbilicalarteryatbirth,fetalheartratepatter`ns(FHR)duringlaobrandinfantlong-termoutcome.Methods　2981caseswithsingletontermpregnancywereselectedforre

5、trospectivecase-controlstudy.Fetalmonitoringwasperformedperiodicallyduringlaborandumbilicalbloodgaswasanalyzedatbirthandtheinfantsoutcomewasfollowedupatage4.Results　Therewere47infantswithpuremetabolicacidemiaand67infantswithmixedacidemia.Theincidence

6、ofFHRscore＜6and6-7attheendoffirststagewassignificantlyhigherinthetwostudygroupsthanthatinthecontrolgroup.Latedecelerationwasassociatedwithpuremetabolicacidemiaandcomplicatedvariabledecelerationwithmixedacidemia.BothtypesofacidemiawerecorrelatedwithAp

7、garscoresbelow7at1minuteafterbirth.Developmentalscreeningatage4showednosignificantdifferencesbetweenthetwostudygroupsandthecontrolgroups.Inthemixedacidemiagrouptherewereslightlymoreinfantshaddeficitsinspeech/languagedevelopment.Conclusions　Latedecele

8、rationmaybeanindicatorofpuremetabolicacidemiaandcomplicatedvariabledecelerationbeanindicatorofmixedacidemia.BothtypesofacidemiawerecorrelatedwithApgarscoresbelow7at1minuteafterbirth.Therelationbetweenacidemiaatbirthanddeficitinspeech/languagedevelopm