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[胎儿窘迫与新生儿窒息的早期诊断]

[Early diagnosis of fetal distress and neonatal asphyxia].

作者信息

Zhou Z L

机构信息

Xin Hua Hospital Shanghai Second Medical University.

出版信息

Zhonghua Fu Chan Ke Za Zhi. 1991 Jul;26(4):200-4, 250.

PMID:1914652
Abstract

122 cases of high risk pregnancies, consisting of mainly pregnancy-induced hypertension (PIH), medical complications, postmaturity and suspected distress were periodically monitored with 11 biophysical and biochemical assays. Positive prediction accuracy rate was analyzed with a neonatal UA pH less than 7.20 as the criterion of fetal hypoxia and ischemia. A number of predicting items together, namely: NST, the other Manning's 4 items, internal monitoring with abnormal Cardiotocography, meconium deeply stained amniotic fluid, FBS pH less than 7.2, uterine contraction time lasting greater than 37 sec and interval shorter than 70 sec, gave the best sensitivity, specificity, positive and negative prediction rates and total accuracy rate of 71.69%, 84.06%, 77.55%, 79.45% and 78.68% respectively. The causes for false positive and false negative cases were discussed. Special attention must be paid to those cases with low UA pH al though normal Apgar scores during the neonatal period.

摘要

122例高危妊娠病例,主要包括妊娠高血压综合征(PIH)、内科并发症、过期妊娠及可疑胎儿窘迫,采用11项生物物理和生化检测方法进行定期监测。以新生儿脐动脉血pH值小于7.20作为胎儿缺氧缺血的标准,分析阳性预测准确率。多项预测指标联合应用,即无应激试验(NST)、Manning其他4项指标、产时异常胎心监护的内监护、羊水重度粪染、胎儿头皮血pH值小于7.2、宫缩持续时间大于37秒且间隔时间短于70秒,其敏感性、特异性、阳性预测率、阴性预测率及总准确率分别为71.69%、84.06%、77.55%、79.45%和78.68%。对假阳性和假阴性病例的原因进行了讨论。对于新生儿期Apgar评分正常但脐动脉血pH值低的病例必须给予特别关注。

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