产程观察及胎心监护课件

第三产程的监护
SZPT-TL
According to the assessment requirements of party conduct and clean government, combined with the "five regulations" and "five new requirements" of state-owned Enterprise leaders ' integrity and self-discipline
胎心率的监护
1、用胎儿监护仪记录的胎心率，动态变化形式 （1）胎心率（fetal heart rate FHR） （2）胎心率基线（FHR-baseline） （3）周期性胎心率（P-FHR）
According to the assessment requirements of party conduct and clean government, combined with the "five regulations" and "five new requirements" of state-owned Enterprise leaders ' integrity and self-discipline
胎盘剥离征象
1.子宫底上升至脐上，子宫收缩呈球形 2.阴道出现少量流血 3.阴道口外露的脐带自行下降延伸 4.在耻骨联合上方按压子宫下段，子宫底上升脐带不回缩
According to the assessment requirements of party conduct and clean government, combined with the "five regulations" and "five new requirements" of state-owned Enterprise leaders ' integrity and self-discipline
产后观察2小时
1.宫缩强度 2.宫底高度 3.阴道流血 4.产道血肿 5.会阴伤口 6.生命体征 7.产妇主诉 8.膀胱充盈 9.新生儿体检 10.协助哺乳
SZPT-TL
According to the assessment requirements of party conduct and clean government, combined with the "five regulations" and "five new requirements" of state-owned Enterprise leaders ' integrity and self-discipline
外测量 内测量
四步触诊
According to the assessment requirements of party conduct and clean government, combined with the "five regulations" and "five new requirements" of state-owned Enterprise leaders ' integrity and self-discipline
胎心、宫颈、宫口、先露……
According to the assessment requirements of party conduct and clean government, combined with the "five regulations" and "five new requirements" of state-owned Enterprise leaders ' integrity and self-discipline
产 程Байду номын сангаас图
SZPT-TL
According to the assessment requirements of party conduct and clean government, combined with the "five regulations" and "five new requirements" of state-owned Enterprise leaders ' integrity and self-discipline
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特点：子宫一收缩胎心就下降，宫缩停止后胎心即恢复正常。
下降幅度＜50bpm， 时间短，恢复快。早期减速通常 是宫缩时胎头受压，是胎儿脑血流量一过性减少的表现
(无明显伤害) 。
According to the assessment requirements of party conduct and clean government, combined with the "five regulations" and "five new requirements" of state-owned Enterprise leaders ' integrity and self-discipline
According to the assessment requirements of party conduct and clean government, combined with the "five regulations" and "five new requirements" of state-owned Enterprise leaders ' integrity and self-discipline
2、胎心率（FHR）是指正常的胎心率有一定的波动性， 正常波动范围在10-25bpm； P-FHR指计算1分钟内胎心波动的次数，正常＞6次/分
3、胎心变化 According to the assessment requirements of party conduct and clean government, combined with the "five regulations" and "five new requirements" of state-owned Enterprise leaders ' integrity and self-discipline （1）加速反应（acceleration）
Apgar评分依据 肤色 心率 呼吸 喉反射 肌张力
SZPT-TL
According to the assessment requirements of party conduct and clean government, combined with the "five regulations" and "five new requirements" of state-owned Enterprise leaders ' integrity and self-discipline
轻度心动过速：胎心率在160～180次/分之间
According to the assessment requirements of party conduct and clean government, combined with the "five regulations" and "five new requirements" of state-owned Enterprise leaders ' integrity and self-discipline
（2）减速反应（deceleration）
指随宫缩出现的短暂性胎心率减慢。 分为3种类型：早期减速、晚期减速、变异减速。
According to the assessment requirements of party conduct and clean government, combined with the "five regulations" and "five new requirements" of state-owned Enterprise leaders ' integrity and self-discipline
早期减速 ED（early
deceleration）
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早期减速 According to the assessment requirements of party conduct and clean government, combined with the "five regulations" and "five new requirements" of state-owned Enterprise leaders ' integrity and self-discipline
指子宫收缩后胎心率暂时增加15bpm以上、持续时间 超过15秒，是胎儿良好的表现。加速原因多为胎儿躯干或 脐静脉暂时受压。散发的、短暂的胎心率加速无害。
3、胎心变化 According to the assessment requirements of party conduct and clean government, combined with the "five regulations" and "five new requirements" of state-owned Enterprise leaders ' integrity and self-discipline
轻度心动过缓：胎心率在100～119次/分之间
胎心率的监护 According to the assessment requirements of party conduct and clean government, combined with the "five regulations" and "five new requirements" of state-owned Enterprise leaders ' integrity and self-discipline
产程观察及胎心监护
2012年1月11日
According to the assessment requirements of party conduct and clean government, combined with the "five regulations" and "five new requirements" of state-owned Enterprise leaders ' integrity and self-discipline
[ 观察及处理 ]
第三产程
首次脐带处理 观察胎盘剥离 协助胎盘娩出 检查软产道 观察产后出血 新生儿体检 填写分娩记录
协助胎盘娩出
According to the assessment requirements of party conduct and clean government, combined with the "five regulations" and "five new requirements" of state-owned Enterprise leaders ' integrity and self-discipline
[ 第一产程的监护 ]
生活起居（饮食、睡眠、二便、体力、灌肠） 产科检查（全身情况、生命体征、产科情况等） 产程进展（胎心、宫缩、宫颈、宫口、先露、羊水）
According to the assessment requirements of party conduct and clean government, combined with the "five regulations" and "five new requirements" of state-owned Enterprise leaders ' integrity and self-discipline
第二产程的监护
产程观察 指导分娩 分娩时机 消毒准备 保护会阴 协助接生 清理呼吸道 Apgar评分
According to the assessment requirements of party conduct and clean government, combined with the "five regulations" and "five new requirements" of state-owned Enterprise leaders ' integrity and self-discipline