胎兒監(jiān)護的解讀分析

1、產(chǎn)時電子胎兒監(jiān)護,,,主要內(nèi)容,胎監(jiān)應用的歷史應用胎監(jiān)來篩查產(chǎn)時胎兒缺氧的發(fā)展現(xiàn)狀產(chǎn)時缺氧對胎兒及新生兒預后的關系 胎心率與胎兒的生物物理活動的關系產(chǎn)時缺氧的EFM（Electronic Fetal Monitoring）,胎兒監(jiān)護的發(fā)展,fetal monitors today have the following features:Reliable, provided they are regularly maintain

2、ed and serviced User friendly with operating manual and video/DVD FHR recording: by external Doppler ultrasound (US) with autocorrelation by fetal electrode (ECG)Twin monitoringMaternal heart rate Event markerExt

3、ernal tocographyMode, date and time printoutAutomatic maternal blood pressure pulse and SaO2 facility,胎兒心率的發(fā)育,The fetal heart is detectable by transvaginal US as early as 4 weeks after conception At this stage

4、the mean FHR is about 100 bpm. Thereafter it progressively rises, reaching a mean of about 140-150 by 10 weeks menstrual age (8 weeks post conception), and levels off at that rate by the start of the second trimester.F

5、rom 14 weeks to term there is a progressive fall in the mean baseline FHR which is unaffected by whether the fetus is Active or Quiescent This lowering of the baseline rate with gestation is a reflection of the fact tha

6、t the sympathetic autonomic,,胎心率變異,胎兒氧供的來源,Fetal oxygenation is therefore dependent upon many factors in this process. Anything that disturbs this chain of oxygen transfer will potentially affect fetal oxygenation and th

7、e FHR. The key components of the chain are:Maternal blood pressure and oxygenation The integrity of the placenta, specifically the amount of surface area for oxygen transfer The patency of the umbilical cord,胎心減速,From

8、 26 weeks onwards decelerations of the fetal heart should be regarded as abnormal. However, fetal decelerations are a normal feature before 26 weeks,胎兒產(chǎn)時缺氧,IP fetal hypoxia occurs in about 1% of labours. It can lead to o

9、ne of three adverse outcomes:Perinatal death (stillbirths and neonatal deaths) Cerebral palsy Hypoxic ischemic encephalopathy (HIE),胎兒缺氧的機制與結(jié)局,Hypoxia may present chronically or acutely.Chronic hypoxia evolves throug

10、h a series of sequential changes. Acute hypoxia also evolves through a different series of sequential changes. However, both routes eventually can lead to the common outcome,判讀胎兒電子監(jiān)護圖形的基本要點,,,,基線,變異,加速,減速,宮縮,無宮縮---NST,有規(guī)