单纯性单脐动脉胎儿围产期结局及分娩方式研究

Study on perinatal outcome and delivery modes of the fetuses with isolated single umbilical artery

目的:探讨单纯性单脐动脉(SUA)胎儿的围产期结局以及分娩方式选择。方法:将68例在该院终止妊娠的单纯性SUA孕妇作为观察组,选择同期126例健康孕妇作为对照组,比较两组分娩方式、胎心监护以及胎儿围产期结局。结果:该院行超声检查的孕妇中SUA发生率为0.43%。观察组因胎儿窘迫直接行剖宫产的比例为42.42%,因胎儿窘迫、羊水污染等胎儿不良事件中转剖宫产的比例为75.00%,总剖宫产率为72.06%,与对照组比较差异均有统计学意义(P<0.05)。观察组胎心监护异常情况发生率显著高于对照组,差异有统计学意义(P<0.05)。观察组胎儿羊水Ⅱ度以上污染、小于胎龄儿的发生率均显著高于对照组,新生儿出生体重显著低于对照组,差异有统计学意义(P<0.05)。结论:单纯性SUA孕妇分娩时需严密观察产程及胎儿宫内情况,可以考虑适当放宽剖宫产指征。

Objective： To explore the perinatal outcome and delivery modes of the fetuses with isolated single umbilical artery （!SUA） . Methods： Sixty- eight 1SUA pregnant women terminating pregnancy in the hospital were selected as observation group, 126 healthy pregnant women during the same period were selected as control group; the delivery modes, fetal heart rate monitoring results and perinatal outcomes in the two groups were compared. Results ： The incidence rate of ISUA among pregnant women receiving ultrasonography in the hospital was 0.43%. In observation group, 42. 42% of the pregnant women converted to cesarean section because of fetal distress, 75.00% of the pregnant women converted to cesarean section because of fetal adverse events, such as fetal distress and amniotic fluid pollution, the total cesarean section rate was 72. 06%, compared with control group, there was statistically significant difference （ P 〈 0. 05 ）. The incidence rate of abnormal fetal heart rate monitoring in observation group was statistically significantly higher than that in control group （ P 〈 0. 05 ） . The incidence rates of fetal amniotic fluid pollution above degree Ⅱ and small for gestational age infants in observation group were statistically significantly higher than those in control group （ P 〈 0. 05 ） . The neonatal birth weight in observation group was statistically significantly lower than that in control group （ P 〈 0. 05 ） . Conclusion ： Stages of labor and fetal intrauterine situations should be observed closely when ISUA pregnant women gave birth to their babies, and the indications of cesarean section may be considered to relax.