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广州一医院远程监控发现胎儿窘迫,9分钟剖宫产出男婴

2017-09-06 蔡敏婕、林伟吟 中国新闻网

中山大学孙逸仙纪念医院6日称,30岁的黄女士通过远程胎儿监控显示胎心下降。该院医生考虑“胎儿窘迫”如继续妊娠不排除胎死宫内等可能,召产妇急诊入院,建议行剖宫产,黄女士及家属表示理解,要求急诊剖宫产。仅9分钟就顺利生下男婴,母子平安。30岁的黄女士多年不孕,4年来做了3次试管婴儿终于成功,但怀孕期间,被诊断为“宫内合并右侧输卵管妊娠”,也就是子宫内存在一个胚胎,输卵管内也存在一个胚胎,宫内孕合并宫外

中山大学孙逸仙纪念医院6日称,30岁的黄女士通过远程胎儿监控显示胎心下降。该院医生考虑“胎儿窘迫”如继续妊娠不排除胎死宫内等可能,召产妇急诊入院,建议行剖宫产,黄女士及家属表示理解,要求急诊剖宫产。仅9分钟就顺利生下男婴,母子平安。

30岁的黄女士多年不孕,4年来做了3次试管婴儿终于成功,但怀孕期间,被诊断为“宫内合并右侧输卵管妊娠”,也就是子宫内存在一个胚胎,输卵管内也存在一个胚胎,宫内孕合并宫外孕。

中山大学孙逸仙纪念医院妇产科围产专科副主任陈慧称,存在于输卵管内的胚胎一旦破裂出血,孕妇将有生命危险。黄女士在该院接受“腹腔镜下右侧输卵管切除术”,宫内胎儿茁壮成长、发育良好。

然而,黄女士又出现妊娠期糖尿病,使得原本就高危产妇面临更多不利因素。医生决定在黄女士晚孕期采用远程胎监,让胎心监测工作在家进行,将监测结果及时发送给产检医生,由产检医生判断结果后及时告知孕妇该如何行动。

9月2日,已经怀孕36周+4天的黄女士,晚饭后感觉胎动明显减少,她开启了远程胎心监测,并将结果及时发送给医院。中山大学孙逸仙纪念医院妇产科围产专科主治医师付帅收到结果后立即查看,发现胎儿存在变异减速,胎心最低时仅85次/分,是正常胎心的一半,考虑症状为“胎儿窘迫”,立刻通知孕妇急诊入院。

考虑如继续妊娠不排除胎死宫内等可能,医生建议黄女士立即行剖宫产,黄女士及家属表示充分理解,要求急诊剖宫产。最终于9月3日凌晨1点10分开始手术,仅9分钟就顺利生下男婴,母子平安。

陈慧介绍,像黄女士这样既是试管受孕又是妊娠期糖尿病,就属于高危妊娠,易发生胎儿缺氧,甚至是胎儿窘迫。胎儿窘迫,处理难点在于及早发现异常、及时终止妊娠。

付帅称,该院自2015年起在广州较早便已配备了远程可穿戴的胎监检测器,妊娠28周以后的高危孕妇,或者妊娠30周以后的正常孕妇,均可在家里使用,医护人员可随时远程判读孕妇胎监情况,以便在胎儿缺氧时,给予及时提示以便进一步检查处理。

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