胎心监测联合超声脐动脉血流监测对胎儿窘迫的诊断价值

目的 探索胎心监测联合超声脐动脉血流监测对胎儿窘迫的诊断价值.方法 对2015年1月至2017年1月于新乐市医院行胎心监测及超声脐动脉血流监测并分娩的孕妇240例进行回顾分析,其中经检测脐血p H值<7.0证实为胎儿窘迫者120例,非胎儿窘迫120例,入选孕妇分别行胎心监测及超声脐动脉血流监测检查;并采用平行(并联)试验对两种监测方法进行联合诊断结果判定,即胎心监测或超声脐动脉血流监测任意一项检测结果阳性,即诊断为阳性;最终将三种诊断结果与分娩后及脐带血pH诊断结果进行对照分析.结果 联合监测诊断胎儿窘迫灵敏度为77.50%,特异度为50.83%,假阳性率为22.50%,假阴性率为49.17%,Youden指数0.2833.联合监测诊断结果明显优于单独监测,差异有统计学意义(χ2=11.9070,P=0.0006).结论 胎心监测联合超声脐动脉血流监测对胎儿窘迫的诊断具有一定价值.

The Diagnostic Value of Fetal Heart Monitoring Combined with Ultrasound Umbilical Artery Blood Flow Monitoring For Fetal Distress

Objective To observe the diagnostic value of fetal heart monitoring combined with ultrasound umbilical artery blood flow monitoring for fetal distress .Methods The data of 240 pregnant women giving birth and receiving the fetal heart monitoring combined with ultrasound umbilical artery blood flow monitoring in Xinle Hospital from January of 2015 to January of 2017 were analyzed retrospectively .120 cases were proved as fetal distress since the pH .value of umbilical blood was lower than 7 .0 and the other 120 cases were verified as non-fetal distress .The included pregnant women received both fetal heart monitoring and ultrasound umbilical artery blood flow monitoring .The parallel test was used to estimate the combined diagnostic results and the case with any positive result by the fetal heart monitoring or ultrasound umbilical artery blood flow monitoring was diagnosed as positive .Finally ,the three diagnostic results were analyzed comparatively with the diagnostic results by the pH value of umbilical blood .Results The fetal distress sensitivity of the combined monitoring was 77 .50% ,its specificity was 50 .83% ,its false positive rate was 22.50% ,its false negative rate was 49.17% ,and its Youden index was 0 .2833 .The diagnostic results of the combined monitoring were significantly superior to those of the single monitoring (χ2 =11 .9070 ,P=0 .0006) .Conclusion The fetal heart monitoring combined with ultrasound umbilical artery blood flow monitoring is of certain value in the diagnosis of fetal distress .