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___________基于經(jīng)腹胎兒心電技術(shù)的胎心率記錄質(zhì)量分析_________

Analysis on recording quality of fetal heart rate based on long-term transabdominal fetal electrocardiogram

作者:               閆亭亭  李旭雯  陳奕  田寧  馬瑩  張松  楊琳  張蕾          
單位:           北京工業(yè)大學(xué)生命科學(xué)與生物工程學(xué)院(北京100124)    
關(guān)鍵詞:           Monica  AN  24;胎兒心電圖;產(chǎn)前連續(xù)胎心監(jiān)護(hù);記錄質(zhì)量;孕婦腹圍      
分類號(hào):           R318.04    
出版年·卷·期(頁(yè)碼):2016·35·4(418-421)
摘要:

目的 研究基于母親腹部胎兒心電(fetal electrocardiogram, fECG)提取技術(shù)的便攜式胎兒/母體心率記錄儀Monica AN24行連續(xù)監(jiān)護(hù)的胎兒心率記錄質(zhì)量(recording quality, RQ),以驗(yàn)證和評(píng)價(jià)fECG技術(shù)采集非產(chǎn)時(shí)胎兒心率的可行性以及準(zhǔn)確率。方法 將98例孕36~41+6周的孕婦納入本研究,使用胎兒/母體心率記錄儀Monica AN24連續(xù)記錄15h胎兒心率數(shù)據(jù),記錄每小時(shí)以及15h平均記錄質(zhì)量;當(dāng)RQ≥60%時(shí),定義記錄質(zhì)量良好。結(jié)果 16.8%的病例出現(xiàn)單小時(shí)RQ低于60%,100%病例在連續(xù)15h監(jiān)護(hù)時(shí)間內(nèi)RQ≥60%。不同時(shí)段RQ總體具有統(tǒng)計(jì)學(xué)差異,P<0.001,在夜間(4:00am-5:00am)RQ達(dá)到最大值(98.6%±4.2%)。在該時(shí)段,不同孕周RQ、高危與無合并癥孕婦RQ在組間不存在統(tǒng)計(jì)學(xué)差異;RQ與孕婦BMI、孕婦腹圍、胎兒體重不存在顯著相關(guān)性。結(jié)論 采用fECG技術(shù)可獲得良好的RQ,在夜間4:00am-5:00am時(shí)間段達(dá)到最高值,且RQ不受孕周、孕婦BMI及孕婦腹圍等因素影響,可作為連續(xù)監(jiān)護(hù)高危胎兒心率的有效方法。

Objective To analyze and evaluate the feasibility and accuracy of fetal heart rate of recording quality (RQ) based on long-term transabdominal fetal electrocardiogram (fECG). Methods According to the inclusion criteria (singleton, 36-41+6 weeks), 98 cases were enrolled in this study. Monica AN24 continuously recorded fetal heart rate for 15 hours, obtaining RQ of 15 hours and RQ of each hour. When RQ≥60%, it was defined qualified. Results There were 16.8% cases of RQ of each hour lower than 60%, 100% cases of RQ of 15 hours were larger than 60%. RQ of 4:00 am-5:00 am was the best (98.6%±4.2%), and there was no statistical significance among different gestational age, between high risk and low risk pregnant woman in this period. There was no correlation between RQ and maternal BMI, fetal weight, as well as abdominal circumference. Conclusions Qualified RQ can be obtained from Monica AN24 and RQ is not affected by gestational age, maternal BMI, maternal abdominal circumference, etc. fECG is an effective method of monitoring fetal heart rate of high-risk cases continuously.

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