脐血流测定对脐带绕颈的产时监护

Intrapartum Fetal Monitoring with Doppler Umbilical Artery Flow Velocimetry for Nuchal Cord

目的 :研究脐血流测定对脐带绕颈的产时监护作用。方法 :对 5 5 0例单胎足月妊娠孕妇进行脐血流测定 ,其中脐带绕颈 138例。分A、B、C 3组 ,分析其产时胎儿宫内窘迫发生率 (简称 :胎窘率 )及剖宫产率 ,并动态观察 14 0例(其中脐带绕颈 5 2例 ,无绕颈 88例 )产妇 ,产程中的脐血流变化。结果 :3组脐带长度、绕颈周数、新生儿Apgar评分 ,差异无显著性 (P >0 0 5 )。B组与C组的产时胎窘率及剖宫产率均较A组高 (P <0 0 1,P <0 0 5 )。产程中 ,S/D升高 >0 1,有脐带绕颈组明显高于无绕颈组 (P <0 0 1) ,S/D >3 0与 2 70 <S/D <3 0时胎儿宫内窘迫发生率差异无显著。结论 :S/D≥ 3 0为异常界限 ,数值偏高 ;S/D正常 ,其余 3项有异常时 ,胎儿宫内窘迫发生率及剖宫产率不下降 (P <0 0 5 )。S/D波动在正常范围 ,产程中可有升高 ,应动态观察 。

Objective:To study the effect of intrapartum fetal monitoring of Doppler umbilical artery flow velocimetry for nuchal cork.Methods:Doppler Umbilical artery Flow Velocimetry was used in 550 women of term singleton pregnancy during labouring Among them,138 were complicated with nuchal cord.All cases were divided into 3 groups Group A,S/D?PI?RI?FVR were all normal Group B,S/D?PI?RI?FVR were all abnormal.Group C one of S/D?PI?RI?FVR was abnormal at least Analysis the rate of fetal distress and cesarean were analysised 140 women(52 cases with nuchal cord,88 cases not with nuchal cord) had been observed the changes of Doppler umbilical artery flow during labouring.Results:The rate of fetal distress and cesarean(because of fetal distress) in group B and C were higher than in group A( P <0.01, P <0.05) The numbers of S/D rised >0 1 during intrapartum were significantly aigher in nuchal cord group than in group there were no nuchal cord( P <0 01) The rate of fetal distress was no significant difference between those of S/D>3 0 and those of 2 70<S/D<3 0 Conclusion:S/D>3 0 as a standard of abnormal is higher than that of observed,the S/D may be increased during intrapartum We should observe it contineously,and bring into full play the action of umbilical artery flow velocimetry combined with fetal monitoring