头位脐带绕颈428例临床分析

Clinical Analysis on 428 Cases With Umbilical Cord Around Neck

目的探讨脐带绕颈对孕妇分娩方式及对围产儿的影响,正确处理脐带绕颈,提高产科安全性。方法回顾本院2005-01/2008-12已分娩的有脐带绕颈孕妇428例,分析脐带长度与脐带绕颈的关系,脐带绕颈对孕妇分娩方式及对围产儿的影响。结果脐带绕颈1周占多数,占79.67%,脐带过短组无1例发生脐带绕颈,脐带过长组的脐带绕颈周数多于脐带正常者(P<0.01),脐带绕颈的产妇胎儿窘迫发生率17.52%,新生儿窒息率5.14%,剖宫产率56.54%,均明显高于对照组(P<0.01)。结论加强产前B超检查和产程胎心监护,重视脐带绕颈这一因素,选择适当分娩方式,以降低胎儿窘迫发生率和新生儿窒息、死亡率。

Objective To explore the influence of umbilical cord around neck on delivery of pregnant woman and the impact to perinatal,deal with the umbilical cord around neck correctly and improve the safety to obstetric.Methods A review was conducted among 428 pregnant women with umbilical cord around neck deliveried in our hospital during January 2005 to December 2008.The relationship between the umbilical cord length and the umbilical cord around neck,its influence on delivery of pregnant woman and perinatal were analyzed.Results Umbilical cord around neck for 1 week accounted most（79.67%）,no umbilical cord around neck happened in cord short group,wihile happened in long cord group accounted more than in common length group（P0.01）.Among the 428 pregnant women with umbilical cord around neck,the fetal distress rate was 17.52%,the neonatal asphyxia rate was 5.14%,the cesarean section rate was 56.54%,all significantly higher than control（P0.01）.Conclusion It is necessary to strengthen prenatal B ultrasound examination and birth process fetal heart rate monitoring,attention the factor of cord around neck,and select the appropriate mode of delivery,for reducing the incidence of fetal distress,neonatal asphyxia,and mortality.