超声诊断脐带绕颈指导产科分娩方式的价值

Ultrasound Diagnosis of Umbilical Cord around Neck to Guide the Value of Obstetric Delivery

目的探讨超声诊断脐带绕颈指导产科分娩方式的价值。方法选择该院2017年3月-2019年3月在产科住院待产的产妇共计120例,使用多普勒超声对所有产妇进行检查。结果对于初步超声检查,拟诊脐带绕颈2周且力度较紧和脐带绕颈超过2周的产妇共计42例,对于脐带缠绕肢体或背部、腰部的胎儿,指导产妇采用剖宫产结束妊娠。脐带绕颈2周且胎心超过160次/min,指导产妇改变体位、增加吸氧量,纠正胎儿的缺氧情况,复查胎心率恢复在130~160次/min,指导产妇采用自然分娩。术后对产妇进行随访,有41例与超声诊断符合,符合率为97.61%,1例误诊,误诊率为2.39%。该次研究中的所有胎儿未出现宫内窘迫或死亡事件。结论超声诊断脐带绕颈的准确率较高,且该方法具有无创、直观、操作简单的优势,容易在孕产妇中推广应用,其结果可为临床选择科学的分娩方式作为参考,对于保障产科分娩质量、降低围产儿的死亡率具有重要意义。

Objective To investigate the value of ultrasound diagnosis of umbilical cord around the neck to guide the delivery mode of obstetrics.Methods A total of 120 women who were hospitalized in the obstetrics from March 2017 to March 2019 were selected.All women were examined by Doppler ultrasound.Results For the initial ultrasound exami-nation,a total of 42 women who had a umbilical cord around the neck for two weeks and a tighter force and a umbilical cord around the neck for more than 2 weeks were enrolled.For the umbilical cord wound limb or the back and waist of the fetus,the mother was instructed to use the cesarean section to end the pregnancy.The umbilical cord was wrapped around the neck for 2 weeks and the fetal heart rate exceeds 160 beats/min.It guided the woman to change her posi-tion,increase the oxygen uptake,correct the fetal hypoxia,and check the fetal heart rate to recover at 130-160 beats/min,guiding the mother to adopt natural delivery.Follow-up of the maternal follow-up,41 cases were consistent with ultrasound diagnosis,the coincidence rate was 97.61%,1 case was misdiagnosed,the misdiagnosis rate was 2.39%.All fetuses in this study did not have intrauterine distress or death.Conclusion Ultrasound diagnosis of umbilical cord around the neck is more accurate,and the method has the advantages of non-invasive,intuitive and simple operation.It is easy to be popularized and applied in pregnant women.The results can be used as a reference for clinically selected scientific delivery methods,which is of great significance for the labor quality and reducing the mortality rate of perina-tal children.