Murlewska Julia, Sylwestrzak Oskar, Witkowski Sławomir, Respondek-Liberska Maria, Słodki Maciej, Strzelecka Iwona
Department of Prenatal Cardiology, Polish Mother's Memorial Hospital Research Institute, 93-338 Lodz, Poland.
Department of Diagnoses and Prevention of Fetal Malformations, Medical University of Lodz, 90-419 Lodz, Poland.
J Clin Med. 2023 Sep 24;12(19):6170. doi: 10.3390/jcm12196170.
This study constitutes a description of prenatal echo-sonographic parameters in fetuses wrapped with the umbilical cord in the third trimester of pregnancy and demonstrates the practical importance of the umbilical cord collision. Echocardiographic examinations were performed within 6 months, and a group of patients in the third trimester with a mean age of 28.1 ± 0.79 weeks of gestation ( = 0.075) was distinguished. The group included 46 fetuses from single pregnancies with the umbilical cord around the fetal neck and 70 fetuses without the umbilical cord around the fetal neck. The course of the umbilical cord coiling around the fetal neck was recorded by color Doppler. We also conducted a follow-up with the newborns. In the study group, there was an elevated peak systolic velocity of the umbilical artery (UMB PSV) at a level of 44.17 cm/s vs. 38.90 cm/s in the control group ( = 0.004), and caesarean sections were significantly more frequent (54.5% vs. 31.4%). The persistence of the nuchal cord during delivery was observed in 37% of newborns in the study group, while the occurrence of umbilical wrapping during delivery was found in 18.6% of newborns in the control group ( = 0.027). In the studied cases, caesarean sections were 2.62 times more frequent (OR = 2.62), whereas nuchal cords during delivery were 2.57 times more often observed (OR = 2.57). Fetal umbilical cord wrapping in the third trimester of pregnancy does not have a significant hemodynamic impact; however, the UMB PSV might be slightly elevated in this group, and the frequency of umbilical cord collision during delivery and the need to perform a caesarean section at term seem to be more common.
本研究描述了妊娠晚期脐带缠绕胎儿的产前超声心动图参数，并证明了脐带碰撞的实际重要性。在6个月内进行了超声心动图检查，区分出一组妊娠晚期平均年龄为28.1±0.79孕周（ = 0.075）的患者。该组包括46例单胎妊娠胎儿，脐带绕颈，以及70例脐带未绕颈的胎儿。通过彩色多普勒记录脐带绕颈的过程。我们还对新生儿进行了随访。研究组脐动脉收缩期峰值速度（UMB PSV）升高，为44.17 cm/s，而对照组为38.90 cm/s（ = 0.004），剖宫产的发生率明显更高（54.5%对31.4%）。研究组37%的新生儿在分娩时观察到脐带持续绕颈，而对照组18.6%的新生儿在分娩时出现脐带缠绕（ = 0.027）。在所研究的病例中，剖宫产的发生率高2.62倍（OR = 2.62），而分娩时脐带绕颈的发生率高2.57倍（OR = 2.57）。妊娠晚期胎儿脐带缠绕对血流动力学没有显著影响；然而，该组的UMB PSV可能略有升高，分娩时脐带碰撞的频率和足月时进行剖宫产的必要性似乎更常见。
