胎儿脐带绕颈动态监测  

Dynamic monitoring of fetal nuchal cord

作　　者：覃桂灿 宁加玲[2] 陈彦红[1] 许春梅[1] 肖艳菊[1] 胡巧[1] 邬华[3] 

机构地区：[1]广西壮族自治区人民医院超声科,广西南宁530021 [2]广西壮族自治区人民医院病案信息科,广西南宁530021 [3]广西壮族自治区人民医院产科,广西南宁530021

出　　处：《中国医学影像技术》2015年第3期434-437,共4页Chinese Journal of Medical Imaging Technology

基　　金：广西卫生厅自筹课题(Z2010257)

摘　　要：目的观察脐带绕颈在孕期中的自然变化。方法收集整个孕期均于我院完成规定的超声检查并分娩的孕妇,最终纳入8016胎,根据超声诊断脐带绕颈情况分为脐带绕颈组与无绕颈组。评估脐带绕颈的发生与脐带长度、羊水量及胎儿预后的相关性。结果超声检出脐带绕颈5091胎(5091/8016,63.51%);其中脐带绕颈自然复位2680胎(2680/5091,52.64%)。晚孕期持续脐带绕颈者分娩后绕颈变化率最低(329/1294,25.43%)。脐带绕颈组脐带长度为(53.98±7.70)cm,无脐带绕颈组(51.34±6.20)cm,二者差异有统计学意义(t=15.32,P<0.001)。与羊水量正常、羊水量少相比,羊水量多时,脐带绕颈发生率最高(136/187,72.73%,P<0.05),脐带绕颈与脐带长度、羊水量均呈正相关(P<0.05)。剖宫产及经阴道分娩者中,是否发生脐带绕颈胎儿出生后的Apgar评分差异均无统计学意义(P均>0.05)。脐带绕颈组剖宫产率高于无绕颈组(χ2=10.23,P<0.05)。结论脐带绕颈多集中发生于中晚孕期,与脐带长度、羊水量具有一定的相关性。Objective To observe the natural change of fetal nuchal cord in the pregnancy.Methods The pregnant women were collected,whoses underwent completed the entire pregnancy of the prescribed ultrasound examination and deliveried in our hospital,eventually including 8016 fetus,and then according to the ultrasound diagnois of fetal nuchal cord,were divided into nuchal cord group and no nuchal cord group.The correlation between fetal nuchal cord with umbilical cord length,amniotic fluid volume and fetal prognosis were evaluated.Results Totally 5091 fetus（5091/8016,63.51%）with nuchal cord were detected by ultrasound,of which 2680 fetus（2680/8016,52.64%）were restoration.The changs rate of persisting nuchal cord in the late pregnancy was the lowest（329/1294,25.43%）.The length of umbilical cord in nuchal cord group was（53.98±7.70）cm,it was（51.34±6.20）cm in the no nuchal group,the difference was statistical significance（t=15.32,P〈0.001）.Compared with the fetus with normal amniotic fluid volume oligohydramnios,the highest incidence of nuchal cord was observed in the fetus with polyhydramnios（136/187,72.73%,P〈0.05）,The nuchal cord were positively correlated with umbilical cord length and amniotic fluid volume（both P〈0.05）.Among the cesarean section and vaginal delivery fetus,the Apgar score between infants with and without nuchal cord both had no statistical significance difference（both P〉0.05）.The cesarean rate of nuchal cord group was higher than that of no nuchal cord group（χ^2=10.23,P〈0.05）.Conclusion The nuchal cord concentrated in middle-late pregnancy,the occurrence of nuchal cord has certain relevance with umbilical cord length and amniotic fluid volume.

关 键 词：超声检查 产前 脐带绕颈 动态监测 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.43[医药卫生—诊断学]