摘要
目的 探索脐带缠绕对围产儿的影响 ,以期确定脐带缠绕的合适处理方法及恰当的剖宫产指征。方法 对我院 1997- 0 1～ 2 0 0 0 - 12单胎头位脐带缠绕 35 7例进行回顾性分析 ,从缠绕的部位、周数、分娩方式等多方面进行对比研究。结果 脐带绕颈 1～ 2周组与无脐带缠绕组在胎儿窘迫、新生儿窒息、新生儿死亡率方面均无显著差异 (P>0 .0 5 ) ;脐带绕颈 3周和绕身、肢体组与无脐带缠绕组比较 ,胎儿窘迫率有极显著升高 (P<0 .0 1) ,胎儿重度窒息率有显著升高 (P<0 .0 5 ) ;脐带缠绕儿经阴道分娩与剖宫产 ,在胎儿窘迫、新生儿窒息、新生儿死亡率方面均无显著差异 (P>0 .0 5 )。结论 产前 B超提示脐带绕颈 1～ 2周者妊娠期、分娩期应加强监护 ,不作为剖宫产指征 ;产前 B超提示脐带绕颈 3周及以上者应视为剖宫产指征。产程中胎心电子监护反复出现中～重度变异减速或伴有其他异常胎心图者应急诊行剖宫产术。
Objective Through investigating the effect of cord entanglement on the perinatal fetus, to determine the appropriate management and the index of operation.Method 357 cases of cord entanglement in singleton pregnancy with head birth from January,1997 to December,2000,were retrospectively analyzed, by studying the entangling site and cycles and delivering mode.Results There was no obvious difference in the morbidity of fetus distress, neonatal asphyxia and death between the cord around neck 1～2 cycle group and the non-cord entanglement group(P>0.05)。But the cord around neck 3 cycles group had significant higher morbility of fetus distress than the non-cord-entanglement group and the cord around body or membrum one had(P<0.01),as neonatal asphyxia(P<0.05)。Thus the fetus born through vagina had no more morbidity of fetus distress, neonatal asphyxia and death than that born by hysterotokotomy in the cord entanglement group(P>0.05)。Conclusion The cord around neck 1～2 cycle indicated by preterm type-B ultrasonic inspection was not the index of hysterotokotomy but should be monitored closely; whereas the cord around neck 3 cycles was the index of hysterotokotomy. In the birth moderate to severe degree or other abnormal rhythm, hysterotokotomy should urgently carried out.
出处
《中国误诊学杂志》
CAS
2001年第8期1153-1155,共3页
Chinese Journal of Misdiagnostics
关键词
脐带缠绕
围产儿
分娩
cord entanglement,perinatal infants,delivery
