Akkaya Hatice, Uysal Gülsüm, Büke Barış, Gök Gamze, Erel Özcan, Karakükçü Çiğdem
a Department of Obstetrics and Gynecology , Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey.
b Department of Obstetrics and Gynecology , Adana Numune Training and Research Hospital , Adana , Turkey.
J Matern Fetal Neonatal Med. 2019 Nov;32(21):3543-3547. doi: 10.1080/14767058.2018.1466273. Epub 2018 Apr 30.
To investigate the serum thiol/disulphide homeostasis in deliveries complicated by nuchal cord (NC) and to compare the results with healthy deliveries (without NC). This prospective controlled study included 48 pregnant women complicated by NC and 48 similar gestational aged healthy pregnant women during labor. Fetal umbilical cord serum samples were collected during labor and the thiol/disulphide homeostasis was measured by using an automated assay method. The patients were followed up until end of the delivery and perinatal outcomes were recorded. Fetal umbilical cord native thiol, total thiol, and disulphide levels as well as disulphide/native thiol and disulphide/total thiol ratios are impaired in labor with the presence of NC. There were no statistically significant differences in terms of maternal and gestational age at delivery and maternal number of gravida and parity, fetal gender, fifth Apgar scores <7, mode of delivery and fetal birth weight between groups. The group of patients with NC had higher emergency C/S numbers indicated for fetal distress and lower first Apgar scores <7. There were no neonatal intensive care unit admissions among these babies. Maternal serum thiol/disulphide homeostasis reflect transient effects of NC during labor regardless of labor type. Vaginal delivery can be safely and successfully performed in pregnancies complicated with NC.
研究分娩时伴有脐带绕颈(NC)的孕妇血清硫醇/二硫化物稳态,并将结果与正常分娩(无NC)的孕妇进行比较。这项前瞻性对照研究纳入了48例分娩时伴有NC的孕妇和48例孕龄相似的正常分娩孕妇。在分娩期间采集胎儿脐带血清样本,并使用自动检测方法测量硫醇/二硫化物稳态。对患者进行随访直至分娩结束,并记录围产期结局。在伴有NC的分娩过程中,胎儿脐带天然硫醇、总硫醇和二硫化物水平以及二硫化物/天然硫醇和二硫化物/总硫醇比值均受到损害。两组在产妇年龄、分娩孕周、产妇孕次和产次、胎儿性别、5分钟Apgar评分<7、分娩方式和胎儿出生体重方面无统计学显著差异。伴有NC的患者组因胎儿窘迫而行急诊剖宫产的次数较多,且1分钟Apgar评分<7的比例较低。这些婴儿中无新生儿重症监护病房入院病例。产妇血清硫醇/二硫化物稳态反映了分娩时NC的短暂影响,与分娩类型无关。伴有NC的孕妇可安全、成功地进行阴道分娩。