Sharma Jb, Goyal Manu
Department of Obstetrics & Gynecology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
J Pak Med Assoc. 2016 Sep;66(9 Suppl 1):S30-3.
Foetal monitoring in antenatal period and during labour is done to detect foetal distress and to take necessary action timely in order to improve perinatal outcome. Maternal awareness of foetal movement is routinely recommended in all pregnancies after 28 weeks gestation. In high risk pregnancies like diabetes, foetal growth restriction, macrosomia, additional means of foetal surveillance should be used like antenatal cardiotocography, non stress test, biophysical profile or Doppler studies. Diabetic mothers are at increased risk for sudden intrauterine foetal demise, thereby mandating the need of cardiotocography and ultrasound biophysical profile testing weekly or twice weekly in such patients. Foetal surveillance in diabetic patients in low resource settings demands for frequent antenatal visits and non stress test if possible. During labour also, there should be continuous electronic foetal monitoring in diabetic mothers in both first and second stages of labour for early detection of foetal hypoxic stre s and timely intervention.
产前和分娩期间进行胎儿监测,以检测胎儿窘迫并及时采取必要措施,以改善围产期结局。常规建议所有妊娠28周后的孕妇了解胎儿胎动情况。在糖尿病、胎儿生长受限、巨大儿等高风险妊娠中,应采用额外的胎儿监测手段,如产前胎心监护、无应激试验、生物物理评分或多普勒检查。糖尿病母亲发生胎儿突然宫内死亡的风险增加,因此这类患者需要每周或每两周进行一次胎心监护和超声生物物理评分检查。在资源匮乏地区,糖尿病患者的胎儿监测需要增加产前检查次数,并尽可能进行无应激试验。在分娩期间,糖尿病母亲在第一产程和第二产程也应进行持续的电子胎儿监测,以便早期发现胎儿缺氧并及时干预。