Sheiner Eyal, Abramowicz Jacques S, Levy Amalia, Silberstein Tali, Mazor Moshe, Hershkovitz Reli
Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben Gurion University of the Negev, Beer-Sheva, Israel.
Arch Gynecol Obstet. 2006 May;274(2):81-3. doi: 10.1007/s00404-005-0110-2. Epub 2005 Dec 23.
The present study was aimed at evaluating the outcome of pregnancies with nuchal cord.
A retrospective population-based study of all deliveries during the years 1988-2003 in a tertiary medical center was conducted. Immediate perinatal outcome of patients with and without nuchal cord was compared.
Of 166,318 deliveries during the study period, 14.7% had a nuchal cord, documented at birth (n=24,392). Higher rates of labor induction and non-reassuring fetal heart rate patterns were noted among pregnancies with nuchal cord as compared with the control group (30.1% vs. 24.2%; OR=1.3, 95% CI 1.3-1.4, P<0.001 and 4.5% vs. 2.6%; OR=1.8, 95% CI 1.6-1.9, P<0.001; respectively). The cesarean delivery rate was significantly lower among pregnancies with nuchal cord (11.5% vs. 12.7%; OR=0.9, 95% CI 0.8-0.9, P=0.001). Although 1 min Apgar scores lower than 7 were more common in pregnancies with nuchal cord (4.8% vs. 4.4%; OR=1.1, 95% CI 1.01-1.2, P=0.008), these pregnancies actually had lower rates of 5 min Apgar scores less than 7 (0.5% vs. 0.7%; OR=0.8, 95% CI 0.6-0.9, P=0.004). Likewise, the perinatal mortality rate was significantly lower in pregnancies with nuchal cord as compared with the comparison group (11/1,000 vs. 16/1,000; OR=0.7, 95% CI 0.6-0.8, P=0.001).
Nuchal cord is not associated with adverse perinatal outcome. Thus, labor induction in such cases is probably unnecessary.
本研究旨在评估脐带绕颈妊娠的结局。
对一家三级医疗中心1988年至2003年期间所有分娩进行基于人群的回顾性研究。比较有和没有脐带绕颈患者的即刻围产期结局。
在研究期间的166,318例分娩中，14.7%有脐带绕颈，在出生时记录（n = 24,392）。与对照组相比，脐带绕颈妊娠中引产率和胎儿心率异常的发生率更高（30.1%对24.2%；OR = 1.3，95%CI 1.3 - 1.4，P < 0.001和4.5%对2.6%；OR = 1.8，95%CI 1.6 - 1.9，P < 0.001；分别）。脐带绕颈妊娠的剖宫产率显著较低（11.5%对12.7%；OR = 0.9，95%CI 0.8 - 0.9，P = 0.001）。虽然脐带绕颈妊娠中1分钟Apgar评分低于7分更常见（4.8%对4.4%；OR = 1.1，95%CI 1.01 - 1.2，P = 0.008），但这些妊娠中5分钟Apgar评分低于7分的发生率实际上较低（0.5%对0.7%；OR = 0.8，95%CI 0.6 - 0.9，P = 0.004）。同样，与对照组相比，脐带绕颈妊娠的围产期死亡率显著较低（11/1000对16/1000；OR = 0.7，95%CI 0.6 - 0.8，P =
