电话远程胎儿监护系统的临床应用

目的 评价电话远程胎儿监护系统的临床应用价值,探索孕妇家庭自我监护的新途径。方法将２０４例妊娠合并贫血、糖尿病、溶血、肾脏疾病、胎儿宫内发育迟缓、妊高征的孕妇、分为试验组（９７例）和对照组（１０７例）。试验组以是锭程胎儿监护系统结合胎动计数进行自我     

远程胎儿监护在脐带绕颈孕妇产前自我保健中的作用

目的　探讨远程胎儿监护对提高脐带绕颈孕妇产前保健质量的作用。方法　根据家庭自我监护方式的不同 ,将脐带绕颈的孕妇分为试验组和对照组 ,试验组 (896例 )为远程胎儿监护和胎动计数者 ;对照组 (1914例 )为单纯胎动计数者。分别统计两组无负荷试验 (NST)、胎儿宫内窘迫、新生儿窒息、医院内外死胎、死产的资料。结果　试验组远程NST为反应型、无反应型和变异减速频繁发生的百分率 (分别为 2 5 6 %、16 1%、5 9 1% )与试验组常规NST(分别为 33 7%、11 5 %、33 4 % )和对照组常规NST(分别为 30 8%、12 1%、31 8% )比较 ,差异均有显著性 (P <0 0 5 ) ;试验组和对照组常规NST比较 ,差异无显著性 (P >0 0 5 )。试验组胎儿宫内窘迫检出率 (35 0 % )较对照组 (30 9% )明显升高 (P <0 0 5 ) ;试验组新生儿窒息的发生率 (3 5 % )较对照组 (5 6 % )明显降低 (P <0 0 5 )。医院外试验组死胎发生率 (0 1% )较对照组 (0 8% )明显降低 (P <0 0 1) ;两组医院内死胎发生率比较 ,差异无显著性 (P >0 0 5 ) ;两组间分娩方式比较 ,差异无显著性 (P >0 0 5 )。结论　远程胎儿监护可降低脐带绕颈孕妇新生儿窒息的发生率 ,减少医院外死胎的发生率 ;对手术产率无明显影响。远程胎儿监护为脐带绕颈孕妇家庭自     

远程胎儿监护网络用于高危妊娠监测的临床价值

目的　探讨远程胎儿监护网络监测高危妊娠的价值。方法　选择 116例高危妊娠孕妇 ,采用远程胎儿监护网络进行无负荷试验 (NST)监测 (研究组 ) ,选择同期进行常规胎儿监护 (胎动计数和定期到医院进行NST监测 )的高危孕妇 12 0例作为对照 (对照组 ) ,分析两组胎儿监护的监测结果、新生儿预后和剖宫产情况。结果　研究组孕期胎儿监护次数为 (9 2± 4 9)次 ,明显高于对照组的(2 6± 1 3)次 (P <0 0 0 1) ,而两组监护费用相当。研究组新生儿窒息和早产发生率分别为 10 3%和12 6 % ,低于对照组的 2 0 8%和 2 4 5 % ,差异有显著性 (P <0 0 5 )。研究组NST异常者新生儿预后不良的发生率为 6 4 8% ,NST正常者新生儿预后不良的发生率为 17 7% ,两者比较 ,差异有显著性 (P<0 0 5 )。研究组行剖宫产和NST异常行剖宫产者的新生儿预后不良发生率分别为 75 9%和 71 7% ,与对照组 (75 0 %和 6 0 6 % )比较 ,差异均无显著性 (P >0 0 5 )。结论　应用远程胎儿监护网络进行高危妊娠的监测 ,可减少新生儿窒息和早产的发生 ,而对剖宫产率无影响 ,为高危妊娠的自我监护提供了一种可靠的新手段     

立体化远程胎儿监护网络的应用

产科医生一直梦想电子胎儿监护 (ＣＴＧ)能够超越时间和空间的限制。远程医疗和社区医疗日益受到政府和人民的重视 ,孕妇迫切需要一种可靠、经济的自我家庭监护方法。胎儿监护“无纸病案”的报道和远程胎儿监护的尝试始于1979年 ,2 0多年来人们探索了许多远程胎儿监护的方法 ,许多城市医院陆续创建了远程胎儿监护中心 ,但如何建设远程胎儿监护网络 ?如何推广这项技术并让孕妇接受认可 ?我们在重庆进行的一些探索和尝试表明 ,建设立体化远程胎儿监护网络 ,有助于围产期保健质量的提高 ,产生良好的社会和经济效益。一、立体化远程胎儿监护网络…     

胎儿远程监护系统在产科的应用

目的　对胎儿远程监护系统进行临床应用与评价。方法　应用胎儿远程监护系统对晚期妊娠妇女进行监护 ,并与美国HP公司的 135 1型胎儿监护仪比较。结果　与美国HP公司的 135 1型胎儿监护仪相比较 ,胎儿远程监护系统瞬时胎心率检测符合率为 96 % ,两种仪器的NST结果相一致。胎儿远程监护系统的网络传输及电话网远程传输数据符合率为 94%。结论　胎儿远程监护系统临床性能稳定可靠 ,该仪器对高危妊娠的监测提供了一个新的手段。     

远程胎儿监护的临床应用

远程胎儿监护是应用互连网及计算机技术,孕妇在家中或远程监护终端将胎心监护图形传输到中央监护站,医生即可通过电脑或手机APP远程判读。对高危孕妇实行远程监护,便于及时发现胎儿宫内缺氧情况和及时处理,改善围产儿结局。     

胎儿监护计算机分析系统的临床应用

胎儿监护作为一个重要的监测胎儿宫内安危的手段已在国内外普及应用。胎儿监护改善了围产儿预后 ,但是由于胎儿生理和病理状态的多样性 ,导致了胎儿监护图形的多样性 ,外监护时的噪音干扰信号也会引起胎心率记数错误 ,致使人工分析判断胎儿监护假阳性率高 ,不同程度地导致了剖宫产率的增加。应用计算机进行胎儿监护曲线 (ＣＴＧ)分析 ,可以排除判读者的主观性 ,屏除检测中的错误信号 ,客观地分析胎儿监护的各种信息 ,并可进行胎儿监护资料的存储[1] 。因此 ,随着计算机技术的发展 ,很多学者开展了计算机分析ＣＴＧ的研究。现将胎儿监护的计…     

远程胎儿监护的临床意义

1　远程胎儿监护概述远程医疗 (telemedicine)技术已经在临床应用 2 0多年。远程胎儿监护 (remotefetalmonitoring)技术是胎儿监护与远程医疗技术相结合的产物 ,2 0世纪 90年代后期 ,多媒体电脑、Windows操作系统和日新月异的信息技术推动了远程胎儿监护技术的飞速发展。远程胎儿监护有 3种方法 :(1)孕妇租用一台电子胎心监护仪 ,带回家中使用 ,定期将记录的胎心监护图纸或存储的软盘送回医院 ,由产科医生作出分析和诊断。 (2 )利用电话网络实时传输胎心监护信息到医院电脑中央监护站 ,由电脑中央监护站进行胎心监护图形的分析并及时报告。…     

胎儿远程监控系统在产科的应用

目的 对胎儿远监控系统进行临床应用与评价。方法 应用胎儿远程监护系统对是妊娠妇女进行监护,并与美国ＨＰ公司的１３５１型胎儿监护仪比较要与美国ＨＰ公司的１３５１型胎儿监护仪相比较,胎儿远程监护系统瞬时胎心率检测符合率为９６％,两种仪器的ＮＳＴ结果相一致。胎儿远程监护系统的同主电话网远程传输数据符合率为９４％。结论 胎儿远程监护系统临床性能稳定可靠,该仪器对高危妊娠的监测提供了一个新的手段。     

远程胎儿监护在高危妊娠中的临床应用

目的:探讨远程胎儿监护在高危妊娠中的临床应用。方法:2004年3月至2005年6月在产科门诊诊断为高危妊娠的孕妇57例作为研究组,并于孕35周以后用远程胎儿监护终端部分(以远程胎儿监护结合胎动计数进行家庭自我监护),随机选择同期高危妊娠孕妇58例,在家中以胎动计数结合门诊常规NST检查作自我监护,作为对照组,比较两组的NST异常和围生儿不良预后发生率。结果:研究组57例孕妇中,NST异常21例,检出率为37%,对照组58例,NST异常11例,检出率为19%,两组比较差异有显著性(P<0.05),对照组58例中,发生围生儿不良预后27例,发生率为47%,研究组57例中发生围生儿不良预后12例,发生率为21%,两组比较差异有显著性(P<0.05)。结论:应用远程胎儿监护对高危妊娠的监测,可降低新生儿窒息等围生儿预后不良的发生率,为高危妊娠孕妇的自我监护和管理开辟了一条有效、实用、可行的途径。     

远程胎儿心率监护网络在高危妊娠中的临床应用

目的　探讨远程胎儿心率监护网络作为高危妊娠围生期孕妇家庭自我监护方法的临床应用价值。方法　 2 0 0 1年 1月至 2 0 0 4年 7月深圳市第二人民医院选择 1 36例高危妊娠孕妇 ,采用远程胎儿心率监护网络进行无负荷试验 (NST)监测 (研究组 ) ,选择同期进行常规胎儿心率监护的高危孕妇 1 4 0例作为对照 (对照组 ) ,分析两组胎儿心率监护的监测结果和围生儿结局。结果　研究组NST异常检出率 (36 6 %)较对照组 (2 8 3%)明显增高 (P <0 0 5 )。研究组NST异常图形为变异减速、基线变异减少或胎儿心率 (FHR)过缓 ,与对照组比较 ,差异均有显著性 (P <0 0 5 )。研究组新生儿窒息和早产儿的发生率低于对照组 (P <0 0 5 )。两组剖宫产率的差异无显著性 (P >0 0 5 )。结论　应用远程胎儿心率监护网络进行高危妊娠的监测 ,可改善围生儿预后 ,是高危妊娠孕妇自我监护的新选择。     

胎心中央监护及远程监护的评价

胎心中央监护及远程监护是胎儿电子监护和计算机网络技术相结合的结晶,通过网络将医院监护仪与家庭监护仪连接到产科中央监护站,经电脑处理后进行信息贮存和分析,以便更方便、更完善地评价胎儿状况,有效改善胎儿预后。     

中心电子监护系统的临床应用

目的 探讨使用中心电子监护系统对提高产科质量的作用。方法 对１９７９年１１月 １９９８年３月在我院分娩的孕周≥３７周的１２１６例孕妇进行ＣＥＭＳ监护,并与１９９６年１１月至１９９７年３月在我院分娩的孕周≥３７周、未行ＣＥＭＳ监护的１１３７例孕妇（对照组）进行比较,分析两组胎儿窘迫发生率,新生儿窒息发生率,剖宫痃和阴道手术率。结果 姐与则组胎儿窘迫发生率分别为９．８％、１２．８％;新生窒息发生率分别     

Limitations of autocorrelation in fetal heart rate monitoring

Fetal heart rate monitors that use autocorrelation of the ultrasonic fetal signal usually produce a cleaner fetal heart rate record than that obtainable with conventional ultrasonic fetal monitors. However, since the autocorrelation function will emphasize any periodic signal originating from the fetus or the mother, in clinical situations the resultant fetal heart rate tracing may contain spurious data. To illustrate the limitations of the autocorrelation technique in fetal monitoring, we compared the autocorrelated ultrasound fetal heart rate records from 23 patients in active labor with the simultaneously recorded direct scalp fetal electrocardiogram tracings. The results indicate that every hour of recording contained, on the average, five instances in which data were missing (range, 0 to 13), four in which data were added (range, 0 to 23), and seven instances in which data were absent for greater than 1 minute (range, 0 to 26). The potential problem of misinterpretation of autocorrelated fetal heart rate data is discussed.     

Maternal self-administered fetal heart rate monitoring and transmission from home in high-risk pregnancies.

OBJECTIVES: To evaluate the feasibility of high-risk pregnancy surveillance by patient-directed fetal heart rate monitoring and transmission, and to assess patient satisfaction with this technology. METHODS: Thirty-six women with high-risk pregnancies performed daily non-stress tests at home and transmitted the data to our perinatal care center by telephone. At each transmission, patients were asked by a physician about perceived fetal movements and uterine contractions and given the results. If the tracing was unsatisfactory, further evaluation was performed. In addition, patients completed a questionnaire on quality of life and anxiety state before and after the study. RESULTS: All patients were able to perform the tests and transmissions. The quality of recorded data was significantly correlated with maternal body mass index, but not with gestational age at the time of monitoring or birth weight. Thirty-nine of the total 562 tracings (6.9%) were inconclusive or non-reassuring. After repeated testing, 32 of them (82%) were considered normal, and seven patients (18%) were referred for additional in-hospital evaluation. Of this group, four were discharged for further surveillance with routine home monitoring and the remaining three were hospitalized for continued evaluation. There were no significant immediate adverse maternal or neonatal outcomes as a result of the monitoring. Patient satisfaction was high. CONCLUSIONS: Daily home FHR monitoring in high-risk patients is safe and feasible at all gestational ages, based on this initial pilot evaluation. It is easily and reliably performed and accepted by patients with a high level of satisfaction.     

Intrapartum fetal heart rate monitoring in cases of cytomegalovirus infection

OBJECTIVE: Several studies have shown that abnormal intrapartum fetal heart rate patterns are the results from pre-existing fetal brain damage. We evaluated intrapartum fetal heart rate pattern of cytomegalovirus-infected fetuses and correlated the patterns with neurologic outcomes. STUDY DESIGN: Between 1991 and 2001, there were 20 cytomegalovirus-infected fetuses. We selected 40 fetuses as control subjects that were matched for gestational age and birth weight. Fetal heart rate was interpreted according to the guidelines of the National Institute for Child and Human Development. The incidence of abnormal fetal heart rate pattern and umbilical blood gases were compared between both groups. We also investigated the factors that contributed to abnormal fetal heart rate pattern in the cytomegalovirus group. RESULTS: Nonreassuring fetal heart rate patterns (prolonged deceleration and recurrent late deceleration) were observed in 8 of 20 fetuses (prolonged deceleration, 7 fetuses; recurrent late deceleration, 1 fetus) in the cytomegalovirus group and in 3 of 41 fetuses (prolonged deceleration, 1 fetus; recurrent late deceleration, 2 fetuses) in the control group (P<.05, Fisher test). Baseline fetal heart rate variability was minimal in 4 of the 7 prolonged deceleration cases in the cytomegalovirus group. Umbilical pH <7.1 was found for 1 fetus in the cytomegalovirus group. The average umbilical arterial pH values were similar in both the groups. In the cytomegalovirus group, there were no differences in the incidence of contributing factors between 8 fetuses with abnormal fetal heart rate pattern (prolonged deceleration and recurrent late deceleration) and 8 fetuses with no change. There were 3 fetuses with cerebral palsy: 2 fetuses in the no change group and 1 fetus in the prolonged deceleration group. Antigenemia was positive exclusively in 4 cases with abnormal fetal heart rate pattern (P<.05). CONCLUSION: Cytomegalovirus-infected fetuses are more likely to show abnormal intrapartum fetal heart rate patterns than low-risk control fetuses, which suggests that the perinatal detection of cytomegalovirus is necessary to distinguish hypoxic-ischemic encephalopathy.     

产程中持续内监护下行羊膜腔输液及羊水置换治疗胎儿窘迫

目的 探讨产程中持续内监护下行羊膜腔输及羊水置换,对治疗胎儿窘迫的意义。方法 对产程中出现频发可变减速合并羊水胎粪污染者１３６例,随机分为观察组与对照组各６８例,观察组在持续内监护下行羊膜腔输液或羊水置换。对照组给予吸氧、改变体位、静脉输液等治疗。结果观察组经羊膜腔输液５００￣１０００ｍｌ,ＶＤ波消失或明显改善者占９１．２％,同时对观察组中４８例羊水Ⅱ度以上粪染者行羊水置换,其中３９例羊水国 清亮