孕晚期脐带螺旋过密出现时间对羊水指数及妊娠结局的影响研究  

ffects of the time of overdense umbilical cord spiral on amniotic fluid index and pregnancy Outcome during the last trimester of pregnancy

作　　者：白媛媛 姚金翠 李玲 刘巧玲 BAI Yuan-yuan;YAO Jin-cui;LI Ling(Department of Obsterics,The Affiliated Jiangning Hospital of Nanjing Medical Univercity,Nanjing Jiangsu 211100,China;Department of Ultrasound Medicine,The Affiliated Jiangning Hospital of Nanjing Medical Univercity,Nanjing Jiangsu 211100,China)

机构地区：[1]南京医科大学附属江宁医院产科,江苏南京211100 [2]南京医科大学附属江宁医院超声科,江苏南京211100 [3]南京医科大学附属江宁医院妇产科,江苏南京211100

出　　处：《临床和实验医学杂志》2023年第21期2330-2334,共5页Journal of Clinical and Experimental Medicine

基　　金：江苏省卫生计生委科研课题(编号:2019011537)。

摘　　要：目的探究孕晚期脐带螺旋过密出现的时间与羊水指数及妊娠结局的关系。方法回顾性将2021年1月至2023年5月在南京医科大学附属江宁医院检查发现的105例28~41周的脐带螺旋过密孕妇作为观察组,并分为观察1组35例(28~34周),观察2组35例(34+1~37组)、观察3组35例(37+1~41周);同期随机抽取的相应孕周下脐带螺旋正常的患者作为对照组。比较观察组和对照组的羊水过少、1 min Apgar≤7分、剖宫产、胎儿窘迫、胎儿生长受限、临产前和产时胎心异常发生率和新生儿出生体重;比较观察1组、观察2组和观察3组的上述指标。结果观察组中的羊水过少、1 min Apgar评分≤7分、剖宫产、胎儿窘迫、胎儿生长受限、临床前和产时胎心异常的发生率分别为65.71%、7.62%、59.05%、17.14%、15.24%、17.14%、22.86%,均显著高于对照组(19.05%、0.95%、23.81%、1.90%、0.95%、2.86%、3.81%),且观察组新生儿出生体重为(3048.95±581.63)g,显著低于对照组[(3370.28±500.19)g],差异均有统计学意义(P<0.05)。观察1组的羊水过少、剖宫产、胎儿窘迫、临床前和产时胎心异常发生率分别为74.29%、80.00%、28.57%、31.43%、42.86%,均显著高于观察2组(57.14%、54.29%、17.14%、14.29%、17.14%)和观察3组(37.14%、42.86%、5.71%、5.71%、8.57%),差异均有统计学意义(P<0.05),3组在1 min Apgar≤7分、胎儿生长受限方面,差异均无统计学意义(P>0.05);观察1组新生儿出生体重为(2810.33±602.52)g,显著低于观察2组[(3025.14±536.24)g]和观察3组[(3265.10±497.25)g],差异均有统计学意义(P<0.05)。结论脐带螺旋过密出现的孕周越早,羊水过少发生率、剖宫产发生率、临产前和产时胎心异常发生率越高,且胎儿窘迫发生率越高,但新生儿出生体重越轻。Objective To explore the relationship of the occurrence time of umbilical cord helicity during the last trimester of pregnancy with amniotic fluid index and pregnancy outcome.Methods A total of 105 cases of pregnant women with overdense umbilical cord spiral from 28 weeks to 41 weeks examined at The Affiliated Jiangning Hospital of Nanjing Medical Univercity from January 2021 to May 2023 were retrospectively selected as the observation group and were divided into observation group1(28-34 weeks),observation group 2(34+1-37 weeks),and observation group 3(37+1-41 weeks),35 cases in each subgroup.Patients with normal umbilical cord spiral at the corresponding gestational age randomly selected during the same period were selected as the control group.The incidence of oligohydramnios,1 minute Apgar≤7,cesarean section,fetal distress,fetal growth restriction,fetal heart rate abnormalities before and during delivery,and neonatal birth weight between observation group and control group were compared,and the above indicators in observation groups 1,2,and 3 were also compared.Results The incidences of oligohydramnios,1 minute Apgar score≤7,cesarean section,fetal distress,fetal growth restriction,and pre-clinical and intra-partum fetal heart abnormalities in observation group were 65.71%,7.62%,59.05%,17.14%,15.24%,17.14%,and 22.86%,respectively,which were dramatically higher than those in control group(19.05%,0.95%,23.81%,1.90%,0.95%,2.86%,and 3.81%),and the birth weight of newborns in observation group was(3048.95±581.63)g,which was much lower than that in control group[(3370.28±500.19)g],the differences were statistically significant(P<0.05).The incidence of oligohydramnios,cesarean section,fetal distress,preclinical and intrapartum fetal heart abnormalities in observation group 1 was 74.29%,80.00%,28.57%,31.43%,and 42.86%,respectively,which were significantly higher than those in observation group 2(57.14%,54.29%,17.14%,14.29%,and 17.14%)and in observation group 3(37.14%,42.86%,5.71%,5.71%,and 8.57%),the differences

关 键 词：脐带 妊娠结局 不同孕周 脐带螺旋过密 羊水指数 

分 类 号：R714.5[医药卫生—妇产科学]