摘要目的 探讨胎心入室试验(AT)联合人工破膜对预测胎儿宫内窘迫的价值.方法 将2006年5-11月入院后24 h内分娩的658例孕妇(33+5～43孕周)根据胎心入室试验分为低风险组598例和高风险组60例,分析其胎心入室试验、分娩结局、羊水及新生儿Apgar评分.结果 AT示515例为反应型占78.27%,72例为可疑型占10.94%,71例为危险型占10.79%;总的新生儿窒息率为6.53%,反应型窒息率为1.94%,危险型为33.08%;羊水污染率反应型为20.97%,危险型为67.61%,差异有统计学意义(P<0.01).高风险组孕妇可疑型、危险型的羊水污染率及新生儿窒息率均较低风险组孕妇高,2组比较差异有统计学意义(P<0.05).结论 AT反应型可预测在以后的4～5 h胎儿在宫内是安全的,胎心入室试验联合人工破膜可预测胎儿预后.

abstractsObjective To evaluate the value of admission test of fetal heart rate and artificial rup-ture of membrane in predicting fetal distress in labor. Methods 658 pregnant women who had been pregnant for 33+5 to 43 weeks and delivered spontaneously in 24 hours were divided into low risk group(598 cases) and hign risk group(60 cases) according to their admission test. The admission test, result of deliv-ery, amniotic fluid contamination and Apgar scores of newborns were analyzed. Results 515 cases were reactive type(78.27%), 72 cases were equivocal type(10.94%) and 71 cases were ominous type(10.79%). Total incidence of neonatal asphyxia were 6.53%,and it was 1.94% and 33.08% in reactive type subjects and ominous type subjects, respectively. The rates of anmiotic fluid contamination were 20. 97% and 67.61% in reactive type subjects and ominous type subjects (P<0.01). The incidence of reactive type and equivocal type of amniotic fluid contamination and neonatal asphyxia were significantly lower in the low risk group than those in the high-risk group (P<0.05). Conclusions Reactive type of admission test can ensure safety of fetus during the subsequent four to five hours. Admission test of fetal heart rate and artifi-cial rupture of membrane can be used to predict fetal outcome in labor.