189例隐性脐带脱垂临床分析  

Clinical analysis of 189 cases of recessive umbilical cord prolapse

作　　者：孙美玉[1] 姜伟[1] 王冬颖[1] SUN Mei-yu;JIANG Wei;WANG Dong-ying(Department of Obstetrics and Gynecology,Shenyang Women’s and Childre’s Hospital,Shenyang 110011,China)

机构地区：[1]沈阳市妇婴医院妇产科,110011

出　　处：《中国现代药物应用》2020年第11期26-28,共3页Chinese Journal of Modern Drug Application

摘　　要：目的探讨隐性脐带脱垂的高危因素、诊断方法及治疗方式。方法回顾性分析189例隐性脐带脱垂患者临床资料,归纳、分析其高危因素、诊断方法、治疗方式及新生儿预后。结果①高危因素:189例患者中135例有高危因素,其中33例有2个高危因素,10例有3个高危因素。②诊断方法:33例患者表现为胎心异常,其中16例患者存在高危因素,17例患者无高危因素。予吸氧、改变体位等积极治疗后胎心无改善;产前超声检查发现50例患者;内诊发现2例,均为早产、胎儿体重<2500 g、胎膜早破患者;104例患者于其他原因的剖宫产术中发现。③治疗方式:终止妊娠:剖宫产175例,产钳助产4例,臀位助产1例,宫口开全自然顺产1例;待产出院:8例<37周患者待产出院。追踪患者结局:2例患者密切随访过程中早产、脐带脱垂行急诊剖宫产,2例患者孕足月正常分娩无脐带脱垂,4例患者妊娠足月因其他原因行剖宫产术,术中未发现脐带脱垂。④新生儿预后:189例患者中早产儿22例,妊娠足月167例,追踪至产后14 d,均预后良好。结论所有孕妇均有发生隐性脐带脱垂的可能,具有高危因素的孕妇更应提高警惕。妊娠28周后孕妇出现胎心异常应警惕隐性脐带脱垂,超声检查监测是产前确诊脐带异常的最佳方法。不同情况患者应采取不同处理方式。Objective To discuss the high risk factors,diagnosis and treatment of recessive cord prolapse.Methods The clinical data of 189 cases of recessive cord prolapse were analyzed retrospectively.The high risk factors,diagnosis methods,treatment methods and neonatal prognosis were summarized and analyzed.Results①High risk factors:among 189 patients,135 had high-risk factors,33 cases of them had 2 high-risk factors,and 10 cases had 3 high-risk factors.②Diagnosis method:33 cases showed fetal heart abnormalities,16 cases of them had high risk factors,17 cases of them had no high risk factors.Fetal heart rate did not improve after active treatment such as oxygen inhalation and position change.50 cases were found by prenatal ultrasound,2 cases were found by internal diagnosis,all of them were premature delivery,fetal weight<2500 g,premature rupture of membranes,104 cases were found in other reasons of cesarean section.③Treatment methods:termination of pregnancy:175 cases of cesarean section,4 cases of forceps delivery,1 case of breech delivery,1 case of spontaneous delivery;discharged from hospital:8 cases<37 weeks discharged from hospital waiting for labor.Pregnancy outcome follow-up:during the follow-up,2 cases of premature delivery and umbilical cord prolapse were treated by emergency cesarean section,2 cases of normal delivery without umbilical cord prolapse,4 cases of cesarean section due to other reasons,no umbilical cord prolapse was found during the operation.④Neonatal prognosis:of the 189 patients,22 cases were premature and 167 cases were full term pregnant,and were tracked to postpartum 14 d.All had a good prognosis.Conclusion All pregnant women have the possibility of recessive umbilical cord prolapse,and pregnant women with high-risk factors should be more vigilant.Pregnant women who have fetal heart abnormalities after 28 weeks of pregnancy should be alert to recessive umbilical cord prolapse.Ultrasound is the best way to diagnose the abnormality of umbilical cord.Patients in different situations shoul

关 键 词：隐性脐带脱垂 高危因素 诊断 治疗 

分 类 号：R714.434[医药卫生—妇产科学]