胎儿BPS、OCT及CST在羊水偏少孕妇阴道试产中临床意义研究

摘要

目的:探讨胎儿生物物理相评分(fetal biophysical score,BPS)、缩宫素激惹实验(oxytocin challenge test,OCT)及宫缩压力实验(contraction stress test,CST)在羊水偏少孕妇阴道试产中的临床意义.方法:选择2013年1月至2014年1月于保定市第一医院和廊坊市人民医院有完整产科住院资料的足月妊娠羊水偏少的孕妇100例作为研究组,选择同期足月妊娠羊水正常的孕妇100例作为对照组.研究组与对照组孕妇入院后均给予BPS、OCT、CST、Bishop子宫颈成熟度评分.由于入院的每位孕妇的个人实际情况不同,采取处理的方法也不同,尽可能的选择阴道试产.其中全程严密监护实施阴道试产的孕妇,并收集产程中胎儿与母体情况.最后对所收集的两组资料进行回顾性分析.结果:本研究发现出现产前变异减速(VD)的研究组为7例,对照组为5例,且P＞0.05,两组差异比较无统计学意义;产前研究组与对照组均无晚期减速(LD)出现;出现产时变异减速(VD)的研究组为20例,对照组为5例,又P ＜0.05,两组差异比较有统计学意义;产时研究组出现晚期减速(LD)为4例,对照组为3例,且P ＞0.05,两组差异比较无统计学意义.研究组产妇剖宫产率为0.55,对照组产妇剖宫产率为0.69,P＜0.05,两组差异比较有统计学意义.在新生儿生物物理相评分中,研究组新生儿生物物理相评分低于7分的为21例,对照组为8例,P＜0.05,差异有统计学意义;研究组新生儿生物物理相评分低于4分的为4例,对照组为3例,P ＞0.05,差异无统计学意义.新生儿研究组体重为(3.47±0.33)kg,对照组为(3.52±0.31)kg,P＞0.05,此差异不具有统计学意义.结论:医护人员对足月妊娠羊水偏少的产妇患者产前进行全程严密监护,如果患者在身体条件允许的情况下,可以进行阴道试产,以此来降低剖宫产风险,且能够有效的降低剖宫产率.降低医源性手术带来的风险,保护母婴安全.%Objectives:To investigate the clinical significance of fetal biophysical score (BPS),oxytocin irritation experiment (OCT),and uterine contraction stress test (CST) in pregnant women with oligohydramnios.Methods:100 oligohydramnios pregnant women with complete obstetric hospital data in our hospital from January 2013 to January 2014 were selected as study group and 100 full-term pregnant women with normal amniotic fluid were selected as control group.The experimental group and control group received BPS,OCT,CST and bishop of cervical maturity score.Due to the different individual situation of pregnant woman,different treatment methods were adopted.The vaginal delivery pregnant women received close monitoring during the whole process.The fetal and maternal conditions were collected and retrospectively analyzed.Results:There were 7 cases of prenatal variable deceleration (VD) in study group and 5 cases in control group,without statistically significant between the two groups,P ＞ 0.05;no late decelerations occurred in study group and control group (LD);there were 20 cases of prenatal variable deceleration (VD) during labor in study group and 5 cases in control group,with statistically significant difference,P ＜0.05;there were 4 cases of late deceleration (LD) in study group and 3 cases in control group,without statistically significant difference,P ＞ 0.05.The maternal uterine rate in the study group and control group was 0.55 and 0.69 respectively,with statistically significant difference,P ＜ 0.05.In the neonatal biophysical score,there were 21 cases with neonatal biophysical score less than 7 points in the study group and 8 cases in control group,with statistically significant difference,P ＜ 0.05;there were 4 cases with neonatal biophysical score less than 4 points in study group and 3 cases in control group,without statistically significant difference,P ＞ 0.05.The body weight of the newborn in study group was (3.47 ± 0.33) kg,and it was (3.52 ± 0.31) kg in control group,without statistically significant difference,P ＞ 0.05.Conclusion:The whole intensive care should be given to full-term pregnancy with oligohydramnios.To reduce cesarean risk,the patients can try vaginal delivery if in good conditions,which can effectively reduce the rate of cesarean section and the risk of iatrogenic surgical and protect the mother and infant.