Clinical significance of intermittent sinusoidal fetal heart rate at third trimester / 中华妇产科杂志

Objective To investigate clinical significance of intermittent sinusoidal feial heart rate at third trimester.Methods From Jan 2002 to Dec 2010,48 pregnant women at 33 to 41 gestational weeks undergoing electronic fetal heart rate(FHR)monitoring presented with intermittent sinusoidal FHR in Department of Obstetrics and Gynecology,Second School of Clinical Medicine,Jinan University were enrolled in this retrospective study.Twenty-one cases were categorized into continuous group(i.e.with sinusoidal feature and a constant duration≥10 minutes).while the other 27 cases were categorized iuto intermittent group(i.e.with a duration＜10 minutes).In the mean time.76 normal cases were chosen randomly matched as control group.Blood gas and hemoglobin were measured in umbilical artery after fetal head delivery.General neurological system examination were performed in those fetus in hospitalization.The outcome of those fetuses was compared.Results (1)Neonatal complications:the rate of asphyxia,meconium-stained amniotic fluid and fetal anemia were 63%(17/27),33%(9/27)and 63%(17/27)in group of intermittent sinusoidal FHR,which were significantly higher than 1%(1/76),4%(3/76),3%(2/76)in control group(P＜0.05).When compared with 67%(14/21),52%(11/21),76%(16/21)in group of continuous sinusoidal,the statistical difierence were not observed(P＞0.05).(2)Blood gas in neonate:the rates of pH less than 7 were 18%(5/27)in intermittent group,52%(11/21)in continuous group and 0 in control group,which all reached statistical difference among those three groups(P＜0.05).(3)Brain damage and death:the rates of brain damage and death were 48%(13/27)and 11%(3/27)in intermittent group,81%(17/21)and 43%(9/21)in continuous group,and 0 in control group,which all showed significant difference between them(P＜0.05).Conclusion Intermittent and continuous sinusoidal FHR are typical graphics of severe fetal anemia at third trimester.Intermittent sinusoidal FHR is indicative of serious fetal hypoxia.

Clinical Study on Intra-Amiotic Administration of Pulmonary Surfactant for Neonatal Respiratory Distress Syndrome Prophylaxis / 中华围产医学杂志

ObjectiveTo discuss the effects and security o f intra-anmiotic administration of pulmonary surfactant for neonatal respiratory distress syndrome prophylaxis.MethodsForty-five cases of pr eterm delivery with immature fetal lungs were divided into two groups. Fifteen w omen of the study group were administered one dose of pulmonary surfactant into the amniotic cavity and delivered in several hours. Nothing was injected into th e amniotic cavity of the 30 women in the control group. The proportion of NRDS, mortality and the time in hospital were analyzed to make clear whether there wer e any differences between the two groups.ResulstsThere was n o difference between the two groups for neonatal Apgar score. Foam test demonstr ated that the proportion of lung maturity of the neonates was:56.3%(9/16)in the study group, 13.3%(4/30)in the control group,(P