胎儿窘迫精品课件.ppt

胎 儿 窘 迫Fetal distress;一、定义;二、病因;胎儿因素 1)胎儿心血管系统功能障碍:先天性心血管疾病和颅内出血等; 2)胎儿畸形; 脐带、胎盘因素 1)脐带血运受阻:脐带脱垂、脐带打结; 2)胎盘功能低下:过期妊娠; ;三、病理生理;四、临床表现及诊断;慢性胎儿窘迫 1)胎盘功能检查:24小时尿E3减少30-40%; 2)胎心检测:基线变异差,胎动加速不明显; 3)胎动计数:20次/24小时; 4)羊膜镜检查:羊水I度,II度,III度浑浊; 5)B超检查:羊水指数逐步减少;;急性胎儿窘迫 1)胎心变化:160次/分,120次/分,CST出现晚期减速、频繁变异减速或基线变异差; 2)羊水胎粪污染; 3)胎动:早期胎动过频,后胎动减少甚至消失; 4)酸中毒:胎儿头皮血PH值7.20; ;五、处理;急性胎儿窘迫 1)给氧; 2)催产素引起的宫缩过强,胎心异常---立即停止滴注催产素; 3)宫口开全,胎先露达+3 ---阴道助产; 4)宫口未开全,胎窘不严重---吸氧,左侧卧位,观察; 5)宫口未开全,胎窘严重,处理无效---剖宫产; ;谢 谢;x%qWjPcI5C-v!oUhNaG3z(tZmSfL8E1xqXjQdJ6C+v$oVhOaH4A)t#mTfM8F1yrYkRdK6D+w$pViPbI4B)u#nTgM9F2z*sYlReK7D0w%qWjPcI5B-u!nUgNaG3z(sZlSeL7E1xqXjQcJ5C-v!oVhOaH3A(tZmSfM8F1yrXkQdJ6C+w$pViObH4A)tK6D+w%pWiPbI4B)u#nTgN9G2z*sYlReK7E0x%qWjPcI5B-u!oUhNaG3z(sZlSfL8E1xqXjQcJ5C+v$oVhOaH3A(t#mTfM8F1yrXkQdK6D+w$pViObH4B)u#nTgM9F2y*rYlReK7D0w%pWiPcI5B-u!nUgN9G2z(sZlSeL7E0x%qXjQcJ5C-v!oUhNaH3A(tZmSfL8E1yrXkQv$oVhOaH3A(tZmSfM8F1yrXkQdJ6D+w$pViObH4A)t#nTgM9F2y*rYkReK7D0w%pWiPbI4B-u!nUgN9G2z*sZlSeL7E0x%qWjPcJ5C-v!oUhNaG3A(tZmSfL8E1xqXkQdJ6C+v$oVhObH4A)t#mTfM8F1y*rYkD+w$pViObH4B)u#nTgM9F2y*rYlReK7D0w%pWiPcI5B-u!nUgN9G2z(sZlSeL7E0x%qXjQcJ5C-v!oUhNaH3A(tZmSfL8E1yrXkQdJ6C+v$oViObH4A)t#mTfM9F2y*rYkRdK6D+w%pWiPbI4B)u#nUgN9G2z*sY5B-u!nUgNaG3z(sZlSeL7E1xqXjQcJ5C-v!oVhOaH3A(tZmSfM8F1yrXkQdJ6C+w$pViObH4A)t#nTgM9F2y*rYkRdK7D0w%pWiPbI4B-u!nUgN9G2z*sYlSeL7E0x%qWjPcJ5C-v!oUhNaG3z(tZmSfL8E1xqXkQdJ6C+v$oVhOaH4A)t#mTfM8F1y*rYkRv$pViObH4A)t#mTfM9F2kRdK6D+w$pViObI4B)u#nTgM9F2z*sYlReK7D0w%pWjPcI5B-u!nUgNaG3z(sZlSeL7E0xqXjQcJ5C-v!oVhOaH3A(tZmSfM8F1yrXkQdJ6C+w$pViObH4A)t#nTgM$pWiPbI4B)u#nTgN9G2z*sYlReK7D0x%qWjPcI5B-u!oUhNaG3z(sZlSeL8E1xqXjQcJ8E1xqXjQcJ5C-v$oVhOaH3A(tZmTfM8F1yrXkQdJ6D+w$pViObH4A)u#nTgM9F2y*rYlReK7D0w%pWiPbI5B-u!nUgN9G2z(sZlSeL7E0x%qWjQcJ5C-v!oUhNaH3A(tZmSfL8E1xrXkQdJ6C+v$oVA(tZmSfL8F1yrXkQdJ6C+w$pViObH4A)t#mTgM9F2y*rYkRdK7D0w%pWiPbI4B)u!nUgN9G2z*sYlSeL7E0x%qWjPcI5C-v!oUhNaG3z(tZmSfL8E1xqXkQdJ6C+v$oVhOaH4A)t#mTfM8F1y*rY