目的探讨第一产程异常胎心监护图形与新生儿结局的关系,减少新生儿窒息率及并发症。方法2005年6月至2006年8月要院足月单胎头位分娩的产妇,采用随机方式抽取446例。其中第一产程胎心率(FHR)异常图形186例(观察组)和FHR正常图形260例(对照组)的临床资料。结果第一产程异常FHR图形的发生率为41.7%,常见类型为轻度变异减速,轻度心度过速,基线变异减弱。重度变异减速,基线变异减弱,晚期减速、重度心动过缓是导致新生儿窒息的危险因素。观察组羊水污染、新生儿窒息、羊水过少,脐带重度缠绕的发生率和剖宫产率明显高于对照组,(P<0.05)。结论第一产程异常FHR图形的发生率较高,其中晚期减速、重度变异减速、基线缺乏变异及重度心动过缓与胎儿宫内窘迫及新生儿窒息关系紧密。 Objective To investigate the relationship between abnormal fetal heart rate monitoring and neonatal outcomes in the first stage of labor and to reduce neonatal asphyxia and complications. Methods From June 2005 to August 2006, 446 pregnant women with full-term single-head delivery were randomized. Among them, the clinical data of 186 cases with abnormal fetal heart rate (FHR) in the first stage of labor and 186 cases with normal FHR (control group) were collected. Results The incidence of abnormal FHR pattern in the first stage of labor was 41.7%. The common types were mild variant decelerations, mild cardiac tachycardia, and baseline variability. Severe mutation decelerations, baseline variability weakened, late deceleration, severe bradycardia is a risk factor for neonatal asphyxia. Observation group, amniotic fluid contamination, neonatal asphyxia, oligohydramnios, the incidence of severe cord entanglement and cesarean section rate was significantly higher than the control group (P <0.05). Conclusions The incidence of abnormal FHR pattern in the first stage of labor is high. Among them, late decelerations, severe decelerations, baseline deformities and severe bradycardia are closely related to fetal distress and neonatal asphyxia.