【摘要】：目的觀察臍帶繞頸在孕期中的自然變化。方法收集整個孕期均于我院完成規(guī)定的超聲檢查并分娩的孕婦,最終納入8016胎,根據(jù)超聲診斷臍帶繞頸情況分為臍帶繞頸組與無繞頸組。評估臍帶繞頸的發(fā)生與臍帶長度、羊水量及胎兒預后的相關性。結果超聲檢出臍帶繞頸5091胎(5091/8016,63.51%);其中臍帶繞頸自然復位2680胎(2680/5091,52.64%)。晚孕期持續(xù)臍帶繞頸者分娩后繞頸變化率最低(329/1294,25.43%)。臍帶繞頸組臍帶長度為(53.98±7.70)cm,無臍帶繞頸組(51.34±6.20)cm,二者差異有統(tǒng)計學意義(t=15.32,P0.001)。與羊水量正常、羊水量少相比,羊水量多時,臍帶繞頸發(fā)生率最高(136/187,72.73%,P0.05),臍帶繞頸與臍帶長度、羊水量均呈正相關(P0.05)。剖宮產(chǎn)及經(jīng)陰道分娩者中,是否發(fā)生臍帶繞頸胎兒出生后的Apgar評分差異均無統(tǒng)計學意義(P均0.05)。臍帶繞頸組剖宮產(chǎn)率高于無繞頸組(χ2=10.23,P0.05)。結論臍帶繞頸多集中發(fā)生于中晚孕期,與臍帶長度、羊水量具有一定的相關性。
[Abstract]:Objective to observe the natural changes of umbilical cord around neck during pregnancy. Methods A total of 8016 pregnant women who had completed the ultrasound examination and delivered in our hospital during the whole pregnancy period were divided into two groups according to the ultrasonic diagnosis of umbilical cord encircling neck group and non-circumferential group. To evaluate the correlation between the occurrence of umbilical cord around neck and umbilical cord length, amniotic fluid and fetal prognosis. Results 5091 fetuses (5091 ~ 8016, 63.51%) were found to have umbilical cord around neck, and 2680 (2680 ~ 5091, 52.64%) were treated with spontaneous reduction of umbilical cord around neck. The rate of change of umbilical cord around neck after delivery was the lowest (329 鹵1294, 25.43%) in the patients with continuous umbilical cord encircling the neck in the third trimester of pregnancy. The length of umbilical cord was (53.98 鹵7.70) cm, and (51.34 鹵6.20) cm, in the group without cord encircling the neck (t = 15.32, P 0.001), and the length of cord was (53.98 鹵7.70) cm, and (51.34 鹵6.20) cm, (t = 15.32, P0.001). Compared with normal amniotic fluid and less amniotic fluid, the incidence of umbilical cord encircling neck was the highest (136? 187, 72.73%, P0.05). There was a positive correlation between umbilical cord around neck and umbilical cord length and amniotic volume (P0.05). There was no significant difference in post-birth Apgar scores between cesarean section and transvaginal delivery. The cesarean section rate of umbilical cord wound group was higher than that of no neck winding group (蠂 2 = 10.23, P0.05). Conclusion most of the umbilical cord around the neck occurs in the middle and late pregnancy, which is related to the length of umbilical cord and the amount of amniotic fluid.
【作者單位】： 廣西壯族自治區(qū)人民醫(yī)院超聲科;廣西壯族自治區(qū)人民醫(yī)院病案信息科;廣西壯族自治區(qū)人民醫(yī)院產(chǎn)科;
【基金】：廣西衛(wèi)生廳自籌課題(Z2010257)
【分類號】：R445.1;R714.43

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