Beer Noam, Danieli-Gruber Shir, Bardin Ron, Berezowsky Alexandra, Hadar Eran, Arbib Nissim
Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat Gan, Israel.
Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel.
Int J Gynaecol Obstet. 2024 Jan;164(1):166-172. doi: 10.1002/ijgo.14992. Epub 2023 Jul 23.
To evaluate perinatal effects of umbilical cord entanglement (UCE) of different body parts.
The database of a tertiary medical center was retrospectively searched for women who gave birth to a liveborn singleton newborn in 2014-2018. Those diagnosed postpartum with UCE were matched 1:10 with women who were not and compared for adverse obstetric and neonatal outcomes, overall and by site of entanglement.
A total of 14 299 women were evaluated, of whom 1243 were diagnosed with UCE: 78.7% neck, 26% trunk, 6.7% limb. UCE was associated with lower birth weight percentile and higher rate of small for gestational age, but findings were significant only for neck and trunk UCE. On multivariate regression analysis adjusted for maternal age, parity, gestational age at birth, and history of cesarean delivery, UCE was an independent risk factor for nonreassuring fetal heart rate, labor induction, operative vaginal delivery, cesarean delivery, and meconium-stained amniotic fluid, but not for lower absolute birth weight/birth weight percentile, small for gestational age, low 1-min Apgar score, or neonatal asphyxia.
While fetuses with UCE might be more compromised during labor, they apparently recover shortly after birth. The impact on perinatal outcomes was similar for UCE of the neck and trunk and lower for UCE of the limb.
评估不同身体部位脐带缠绕（UCE）对围产期的影响。
对一家三级医疗中心的数据库进行回顾性检索，以查找2014 - 2018年分娩单胎活产新生儿的女性。产后诊断为脐带缠绕的女性与未诊断为脐带缠绕的女性按1:10进行匹配，并比较产科和新生儿不良结局，总体情况以及按缠绕部位进行比较。
共评估了14299名女性，其中1243名被诊断为脐带缠绕：78.7%为颈部缠绕，26%为躯干缠绕，6.7%为肢体缠绕。脐带缠绕与出生体重百分位数较低以及小于胎龄儿发生率较高相关，但仅颈部和躯干脐带缠绕的结果具有统计学意义。在对产妇年龄、产次、出生孕周和剖宫产史进行校正的多因素回归分析中，脐带缠绕是非 reassuring 胎心、引产、阴道助产、剖宫产和羊水粪染的独立危险因素，但与绝对出生体重/出生体重百分位数较低、小于胎龄儿、1分钟Apgar评分低或新生儿窒息无关。
虽然脐带缠绕的胎儿在分娩期间可能受到更大影响，但他们在出生后不久显然会恢复。颈部和躯干脐带缠绕对围产期结局的影响相似，而肢体脐带缠绕的影响较小。
