200例脐绕颈分娩结局分析

Analysis of Labor Outcome on 200 Cases with Umbilical Cord Around the Neck

目的提高脐绕颈围产期处理水平,降低新生儿窒息率。方法随机抽样2003年1月～2007年2月在本院分娩脐绕颈200例,分析妊娠末期、分娩期的临床表现、胎心监护特点。结果彩超准确率95.0%,误诊率为6.87%。初产头浮12.0%,臀位占8%。分娩中胎儿宫内窘迫新生儿窒息发生率混合型最高49.5%,胎心型13.3%,羊水型5.65%。胎心型与羊水型比较差异无显著性(P>0.05),混合型与胎心型比较差异有极显著性(P<0.005)。难产主要表现为胎头下降阻滞。结论对混合型胎儿宫内窘迫伴有中、重度变异减速,应立即终止妊娠,第二产程中阻滞者适当助产。

Objective To improve the level of treatment of the umbilical cord around neck perinatal and reduce the rate of neonatal asphyxia. Methods Random 2003 ～ 2007 year maternity hospital in the umbilical cord around neck 250 eases. Analysis the end of pregnancy, childbirth clinical performance, characteristics of fetal heart rate monitoring. Results Color Doppler accuracy rate was 95.0%, rate of misdiagnosis was 6.87%. Beginning the first floating production 12.0% ,breech presentation accounted for 8.0%. Fetal distress in labor, neonatal asphyxia mixed highest incidence of 49.5%, 13.3% of fetal heart rate,the amniotic fluid of 5.65%. There was no significant difference in type of amniotic fluid and fetal heart rate compared 〉 0.05. Difference was significant with the mixed type of fetal heart rate eompared（P 〈 0.005）. Dystocia decline mainly to the rise block. Conclusion It should be immediately terminate pregnancy for the Mixed with fetal distress,severe slowdown variation, birth process in the second block with the appropriate midwifery.