脐带异常174例临床分析

Chinical analysis of 174 cases with umbilical abnormality

探讨脐带异常的临床表现和产前预测的可能性。方法 :比较脐带正常与脐带异常在分娩方式、羊水性状及新生儿Apgar评分差异 ,以及脐带异常在胎心监护和彩色B超监测的预测值和准确率。结果 :脐带异常发生率为 18.2 0 % ,其中以脐带缠绕发生率占脐带异常的绝大部分 (87.93 % )。初产妇、过期妊娠脐带异常发生率最高。脐带异常发生羊水污染、剖宫产及新生儿低评分均明显高于脐带正常者 (P <0 .0 5 )。胎心监护阳性预测值、准确率分别为 87.2 8%、84.5 5 % ;彩色B超阳性预测值、准确率分别为 95 .15 %、97.92 %。结论 :脐带异常对围产儿存在严重危害。在产前应用胎儿监护、B超预测脐带异常有较高的阳性预测值和准确率。结合临床其它因素可为母婴提供最大的安全保障。

Objective:To find out the manifestation and the probability of prenatal prediction of umbilical abnormality.Method:174 cases with umbilical abnormality were analyzed retrospectively.Result:The occurrence of umbilical abnormality was 18.20%,mostly umbilical twining(87.93%).It was more frequently seen in primiparae and prolonged pregnancy.Pollution of amniotic fluid,Cesarean section and newboms low Apgar score were significantly higher in umbilical abnormality than that of umbilical normality(P<0.05).Electronic fetal monitoring showed that positive predicting value and accuracy was 87.22%,84.55% respectively.And colour B-ultrasound,95.15%,97.92% respectively.Conclusion:Umbilical abnormality is very harmful to perinatal fetus.Fetal monitoring and colour B-ultrasound examination were helpful to the prediction of umbilical abnormality.Combined with other clinical ractors,more security would be provided for mothers and infants.