电子胎儿监护与脐带脱垂新生儿结局。
Electronic Fetal Monitoring and Neonatal Outcomes when a Nuchal Cord Is Present at Delivery.
机构信息
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri.
出版信息
Am J Perinatol. 2020 Mar;37(4):378-383. doi: 10.1055/s-0039-1679866. Epub 2019 Feb 28.
OBJECTIVE
This study aimed to determine the association between nuchal cord, electronic fetal monitoring parameters, and adverse neonatal outcomes.
STUDY DESIGN
This was a prospective cohort study of 8,580 singleton pregnancies. Electronic fetal monitoring was interpreted, and patients with a nuchal cord at delivery were compared with those without. The primary outcome was a composite neonatal morbidity index. Logistic regression was used to adjust for confounders.
RESULT
Of 8,580 patients, 2,071 (24.14%) had a nuchal cord. There was no difference in the risk of neonatal composite morbidity in patients with or without a nuchal cord (8.69 vs. 8.86%; = 0.81). Nuchal cord was associated with category II fetal heart tracing and operative vaginal delivery (OVD) (6.4 vs. 4.3%; < 0.01).
CONCLUSION
Nuchal cord is associated with category II electronic fetal monitoring parameters, which may drive increased rates of OVD. However, there is no significant association with neonatal morbidity.
目的
本研究旨在探讨脐带绕颈、电子胎心监护参数与不良新生儿结局之间的关系。
研究设计
这是一项 8580 例单胎妊娠的前瞻性队列研究。对电子胎心监护进行解读，并比较分娩时存在脐带绕颈与不存在脐带绕颈的患者。主要结局为新生儿复合发病率指数。采用逻辑回归调整混杂因素。
结果
8580 例患者中，2071 例（24.14%）存在脐带绕颈。有或无脐带绕颈的新生儿复合发病率无差异（8.69%比 8.86%； = 0.81）。脐带绕颈与Ⅱ类胎心监护图和阴道助产分娩（operative vaginal delivery，OVD）相关（6.4%比 4.3%； < 0.01）。
结论
脐带绕颈与Ⅱ类电子胎心监护参数相关，这可能导致 OVD 发生率增加。然而，与新生儿发病率并无显著关联。
Zotero 插件