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分娩时的脐带长度与酸碱平衡

Umbilical cord length and acid-base balance at delivery.

作者信息

Berg T G, Rayburn W F

机构信息

Department of Obstetrics and Gynecology, University of Nebraska Medical Center, Omaha, USA.

出版信息

J Reprod Med. 1995 Jan;40(1):9-12.

PMID:7722985
Abstract

An abnormally short or long umbilical cord is associated with a greater risk of cord compression, variable fetal heart rate decelerations and fetal demise. The purpose of the present investigation was to determine whether any relation exists between an abnormal length of the umbilical cord and acid-base imbalance at delivery. Cord lengths were measured routinely in 3,019 consecutive pregnancies undergoing labor beyond 34 weeks. Short cords (13-35 cm) were found in 61 (2.0%) cases and long cords (80-121 cm) in 112 (3.7%) cases. Umbilical blood pH and base deficit values averaged the same for those pregnancies with short (7.35 +/- 0.09 and 3.1 +/- 2.7 mEq/L, mean +/- SD), normal length (7.36 +/- 0.03 and 3.8 +/- 1.7, mEq/L) and long (7.34 +/- 0.06 and 3.7 +/- 3.1 mEq/L) cords. A blood pH < 7.20 was very uncommon in the presence of a short (two cases, 3.3%) or long (five cases, 4.5%) cord and was accompanied by an abnormal fetal heart rate pattern, such as severe variable decelerations or bradycardia. Finding an abnormally short or long umbilical cord at birth is not by itself associated with an increased risk of acid-base imbalance at delivery and does not require routine cord blood gas determination.

摘要

脐带过短或过长与脐带受压、胎儿心率变异减速及胎儿死亡风险增加相关。本研究的目的是确定脐带长度异常与分娩时酸碱失衡之间是否存在关联。对3019例孕周超过34周且正在分娩的连续妊娠病例常规测量脐带长度。发现61例(2.0%)脐带过短(13 - 35厘米),112例(3.7%)脐带过长(80 - 121厘米)。脐带过短(pH值7.35±0.09,碱缺失值3.1±2.7毫当量/升,均值±标准差)、长度正常(pH值7.36±0.03,碱缺失值3.8±1.7毫当量/升)及过长(pH值7.34±0.06,碱缺失值3.7±3.1毫当量/升)的妊娠病例,脐血pH值和碱缺失值平均相同。在脐带过短(2例,3.3%)或过长(5例,4.5%)的情况下,pH值<7.20非常少见,且伴有异常的胎儿心率模式,如严重变异减速或心动过缓。出生时发现脐带过短或过长本身与分娩时酸碱失衡风险增加无关,不需要常规进行脐血气测定。

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