胎儿脐带绕颈动态监测

发布时间：2019-03-07 20:32

【摘要】：目的观察脐带绕颈在孕期中的自然变化。方法收集整个孕期均于我院完成规定的超声检查并分娩的孕妇,最终纳入8016胎,根据超声诊断脐带绕颈情况分为脐带绕颈组与无绕颈组。评估脐带绕颈的发生与脐带长度、羊水量及胎儿预后的相关性。结果超声检出脐带绕颈5091胎(5091/8016,63.51%);其中脐带绕颈自然复位2680胎(2680/5091,52.64%)。晚孕期持续脐带绕颈者分娩后绕颈变化率最低(329/1294,25.43%)。脐带绕颈组脐带长度为(53.98±7.70)cm,无脐带绕颈组(51.34±6.20)cm,二者差异有统计学意义(t=15.32,P0.001)。与羊水量正常、羊水量少相比,羊水量多时,脐带绕颈发生率最高(136/187,72.73%,P0.05),脐带绕颈与脐带长度、羊水量均呈正相关(P0.05)。剖宫产及经阴道分娩者中,是否发生脐带绕颈胎儿出生后的Apgar评分差异均无统计学意义(P均0.05)。脐带绕颈组剖宫产率高于无绕颈组(χ2=10.23,P0.05)。结论脐带绕颈多集中发生于中晚孕期,与脐带长度、羊水量具有一定的相关性。
[Abstract]:Objective to observe the natural changes of umbilical cord around neck during pregnancy. Methods A total of 8016 pregnant women who had completed the ultrasound examination and delivered in our hospital during the whole pregnancy period were divided into two groups according to the ultrasonic diagnosis of umbilical cord encircling neck group and non-circumferential group. To evaluate the correlation between the occurrence of umbilical cord around neck and umbilical cord length, amniotic fluid and fetal prognosis. Results 5091 fetuses (5091 ~ 8016, 63.51%) were found to have umbilical cord around neck, and 2680 (2680 ~ 5091, 52.64%) were treated with spontaneous reduction of umbilical cord around neck. The rate of change of umbilical cord around neck after delivery was the lowest (329 卤1294, 25.43%) in the patients with continuous umbilical cord encircling the neck in the third trimester of pregnancy. The length of umbilical cord was (53.98 卤7.70) cm, and (51.34 卤6.20) cm, in the group without cord encircling the neck (t = 15.32, P 0.001), and the length of cord was (53.98 卤7.70) cm, and (51.34 卤6.20) cm, (t = 15.32, P0.001). Compared with normal amniotic fluid and less amniotic fluid, the incidence of umbilical cord encircling neck was the highest (136? 187, 72.73%, P0.05). There was a positive correlation between umbilical cord around neck and umbilical cord length and amniotic volume (P0.05). There was no significant difference in post-birth Apgar scores between cesarean section and transvaginal delivery. The cesarean section rate of umbilical cord wound group was higher than that of no neck winding group (蠂 2 = 10.23, P0.05). Conclusion most of the umbilical cord around the neck occurs in the middle and late pregnancy, which is related to the length of umbilical cord and the amount of amniotic fluid.
【作者单位】：广西壮族自治区人民医院超声科;广西壮族自治区人民医院病案信息科;广西壮族自治区人民医院产科;
【基金】：广西卫生厅自筹课题(Z2010257)
【分类号】：R445.1;R714.43

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