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过期妊娠中的脐带绕颈——与提示手术干预的可疑产时胎儿窘迫的关系。

Nuchal cord in post-term pregnancy - relationship to suspected intrapartum fetal distress indicating operative intervention.

作者信息

Ghosh Gisela S, Gudmundsson Saemundur

机构信息

Department of Obstetrics and Gynecology, Malmö University Hospital, Malmö, Sweden.

出版信息

J Perinat Med. 2008;36(2):142-4. doi: 10.1515/JPM.2008.012.

Abstract

Color Doppler Ultrasound was performed on 202 post-term pregnancies to detect the presence of a nuchal cord. A nuchal cord was diagnosed if the umbilical cord could be followed 360 degrees around the fetal neck. The results were not disclosed to the managing obstetrician, midwife, and patient. The perinatal outcome was analyzed according to Apgar score, umbilical cord artery and vein pH and base excess (BE), perinatal death, cesarean section, operative delivery for fetal distress (ODFD) and admission to neonatal intensive care unit (NICU). A nuchal cord was detected in 69 patients (34.2%). The incidence was not affected by parity or reduced amniotic fluid volume. There was no statistically significant increased risk for 1- and 5-min Apgar scores <7, umbilical artery pH <7.1, umbilical vein pH <7.20, umbilical artery base excess <-11, umbilical vein base excess <-11, perinatal death, cesarean section, ODFD or admission to NICU. Nuchal cord in post-term pregnancies is not associated with an increased risk for signs of fetal distress and operative intervention during labor and delivery.

摘要

对202例过期妊娠进行了彩色多普勒超声检查,以检测有无脐带绕颈。如果脐带能围绕胎儿颈部完整环绕360度,则诊断为脐带绕颈。检查结果未告知负责的产科医生、助产士和患者。根据阿氏评分、脐动脉和脐静脉pH值及碱剩余(BE)、围产期死亡、剖宫产、因胎儿窘迫行手术分娩(ODFD)以及入住新生儿重症监护病房(NICU)情况分析围产期结局。69例患者(34.2%)检测到脐带绕颈。其发生率不受产次或羊水过少的影响。1分钟和5分钟阿氏评分<7、脐动脉pH<7.1、脐静脉pH<7.20、脐动脉碱剩余<-11、脐静脉碱剩余<-11、围产期死亡、剖宫产、ODFD或入住NICU的风险在统计学上无显著增加。过期妊娠中的脐带绕颈与分娩期间胎儿窘迫体征及手术干预风险增加无关。

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