足月妊娠脐带绕颈分娩方式的探讨

Evaluation of delivery methods of term pregnancy accompanied with umbilical cord winding nape

目的 探讨足月妊娠脐带绕颈在产程中导致胎儿窘迫、新生儿窒息的发生率，选择合适的分娩方式。方法 住院分娩的548例脐带绕颈孕妇为观察组，同期抽取住院分娩的无脐带绕颈的孕妇500例为对照组，分析比较两组孕妇胎儿窘迫、新生儿窒息的发生率、脐带绕颈周数与胎儿窘迫、新生儿窒息的发生率以及孕妇的分娩方式。结果 观察组胎儿窘迫、新生儿窒息的发生率明显高于对照组（P〈0．05）；脐带绕颈1周观察组与对照组比较剖宫产率无明显差异（P〉0．05）；脐带绕颈2～3周观察组与对照组比较其剖宫产率明显升高（P〈0．05）。结论 脐带绕颈1周者，可鼓励孕妇自然分娩，必要时：行剖宫产。脐带绕颈2～3周者，建议孕妇剖宫产分娩。

Objective To evaluate the occurence of fetal distress and asphxia of newborn on account of umbilical cord winding nape in stage of term pregnancy. In order to select proper delivery methods. Methods There were 548 cases with umbilical cord winding nape were Ks.signed into treatment group, and 500 cases without this complication into contrast group. The incidence of fetal distress and asphxia of new born were analyzed two groups, the relationship between circles of umbilical cord and the incidence of fetal distress, and asphxia of newborn and delivery methods were compared. Results The occurence of fetal distress and asphxia of newborn in treatment group is evidently higher than in contrast group（P〈0.05）. There is no significant difference in aspect of fetal distress, asphxia of newborn and cesarean section between umbilical cord one circle and contrast group. There is significant different（P 〈 0.05）between winding 2--3 circles of unbilical cord and contrast group. Conclusion The one eircle of winding nape select spontaneous delivery or cesarean section if necessary. The circles of winding nape were 2- 3 circles should select cesarean section.