Joura E A, Zeisler H, Sator M O
Universitätsklinik für Frauenheilkunde Wien, Allgemeines Krankenhaus, Osterreich.
Wien Klin Wochenschr. 1998 Mar 27;110(6):232-5.
To evaluate the epidemiology of true knots of the umbilical cord and their impact on pregnancy outcome.
22531 singleton deliveries were included in this retrospective study (1976-1994). Newborns with malformations were excluded. The database of the 2nd Department of Obstetrics and Gynaecology, Vienna University Hospital was analyzed.
The incidence of true knots was 1.27% (n = 286). Multiparous women are more likely to give birth to a child with a true knot of the umbilical cord than primiparae (1.52% vs. 1.01%, P < 0.001). Male fetuses are more frequently affected than females (1.49% vs. 1.04%, P = 0.01). Duration of pregnancy, fetal weight, presentation and mode of delivery are not significantly influenced by umbilical knots. Fetal acidosis (pH < 7.10) was more common in the cohort with true knots as compared with the controls (8.33% vs. 4.03%, P < 0.01). Apgar score and transfer rate to a neonatal unit were not influenced. Still-births were more common in the cohort with umbilical knots (1.7% vs. 0.6%, P < 0.05); there was no neonatal death in the cohort with true knots, however.
A fetus with a true knot of the umbilical cord is at risk for fetal death. During labour umbilical knots have no adverse effect on pregnancy outcome.
评估脐带真结的流行病学情况及其对妊娠结局的影响。
本回顾性研究纳入了22531例单胎分娩（1976 - 1994年）。排除有畸形的新生儿。对维也纳大学医院妇产科第二科室的数据库进行了分析。
脐带真结的发生率为1.27%（n = 286）。经产妇比初产妇更易分娩出有脐带真结的胎儿（1.52%对1.01%，P < 0.001）。男性胎儿比女性胎儿更常受影响（1.49%对1.04%，P = 0.01）。妊娠时长、胎儿体重、胎位及分娩方式不受脐带打结的显著影响。与对照组相比，有真结的队列中胎儿酸中毒（pH < 7.10）更常见（8.33%对4.03%，P < 0.01）。阿氏评分和转入新生儿病房的比率不受影响。有脐带打结的队列中死产更常见（1.7%对0.6%，P < 0.05）；然而，有真结的队列中无新生儿死亡。
有脐带真结的胎儿有胎儿死亡风险。分娩期间脐带打结对妊娠结局无不良影响。
