目的探讨活跃早期人工破膜联合胎心监护预测胎儿窘迫的临床价值。方法将在邢台矿业集团总医院分娩的360例产妇随机分成3组:观察组120例采用活跃早期(肛查宫口开大3 cm)行人工破膜,观察羊水性状并行持续胎心监护;对照A组120例采用活跃早期(肛查宫口开大3 cm)行人工破膜,观察羊水性状,未采用胎心监护,按规定每15~30 min采用多普勒监测胎心,每次监测持续1 min;对照B组120例采用活跃早期(肛查宫口开大3cm)行持续胎心监护。对3组胎儿宫内窘迫及新生儿窒息情况进行比较分析。结果观察组发生胎儿宫内窘迫16例,漏诊1例,新生儿窒息3例;对照A组发生胎儿宫内窘迫14例,漏诊8例,新生儿窒息11例;对照B组发生胎儿宫内窘迫15例,漏诊7例,新生儿窒息10例;3组胎儿宫内窘迫漏诊率及新生儿窒息率比较差异均有统计学意义(P<0.05)。结论活跃早期人工破膜联合胎心监护可以准确判断胎儿宫内情况,提高新生儿预后,对降低围生儿死亡,提高围生期质量有重大意义。 Objective To investigate the clinical value of active early rupture combined with fetal heart rate monitoring in predicting fetal distress. Methods 360 pregnant women delivered at General Hospital of Xingtai Mining Group were randomly divided into three groups: 120 cases in the observation group were treated with artificial early rupture of the anterior wall (anal canal opening 3 cm) to observe the amniotic fluid trait and the continuous fetal heart rate monitoring; A group of 120 patients with active early (anal check cervix open 3 cm) artificial rupture of the membrane, observe the amniotic fluid traits, did not use fetal heart monitoring, according to the provisions of every 15 ~ 30 min using Doppler monitoring of fetal heart rate, each monitoring Lasted 1 min; control group B 120 cases of active early (anal check cervix open 3cm) line of continuous fetal heart rate monitoring. Three groups of fetal distress and neonatal asphyxia were compared. Results There were 16 cases of fetal distress in the observation group, 1 case of misdiagnosis and 3 cases of asphyxia in the observation group. There were 14 cases of fetal distress in control group A, 8 cases of misdiagnosis and 11 cases of neonatal asphyxia. In control group B, fetal distress 15 cases, missed diagnosis in 7 cases and neonatal asphyxia in 10 cases. There was significant difference in the rate of misdiagnosis and neonatal asphyxia between the three groups (P <0.05). Conclusions The active early rupture combined with fetal heart rate monitoring can accurately determine the intrauterine situation and improve the prognosis of neonates. It is of great significance to reduce perinatal mortality and improve perinatal quality.