彩超在妊娠晚期胎儿脐带绕颈中的应用价值

Application value of color Doppler ultrasound in the umbilical cord around the neck in the third trimester of pregnancy

目的探讨彩超在妊娠晚期胎儿脐带绕颈中的应用价值。方法选取2018年1月18日~2019年1月18日深圳坪山区妇幼保健院收治的400例妊娠晚期孕妇作为研究对象,根据孕妇腹中胎儿当前窒息状态,分为对照组和观察组,对照组200例无脐带绕颈现象,观察组200例疑似存在脐带绕颈。对其进行彩超检查,随后比较两组胎儿的脐动脉血流阻抗值(S/D)、搏动指数(PI)、阻力指数(RI),并以产中确诊结果作为金标准,分析彩超对胎位异常的诊断正确率以及诊断价值。结果观察组的S/D(3.91±0.51)、RI(0.86±0.51)、PI(0.97±0.76)均高于对照组(2.54±0.32、0.13±0.05、0.32±0.07),差异有统计学意义(P<0.05)。彩超对胎位异常的诊断正确率为95.92%(47/49),其诊断结果与产中确诊结果比较,差异无统计学意义(P>0.05),同时观察组200例疑似存在脐带绕颈中,产中确诊182例,彩超对妊娠晚期孕妇的诊断敏感度为98.90%,特异度为94.44%,漏诊率为1.10%,误诊率为5.56%。结论在诊断妊娠晚期胎儿有无脐带绕颈时,还需首选彩超检查,从而提高诊断正确率,为分娩方式选择提供可靠依据。

Objective To explore the application value of color Doppler ultrasound in the umbilical cord around the neck in the third trimester of pregnancy.Methods A total of 400 cases of pregnant women who were admitted to Maternal and Child Health Hospital of Pingshan district in Shenzhen city from January 18,2018 to January 18,2019 were selected as the research subjects.According to the current state of fetal asphyxia in pregnant women,they were divided into the control group and the observation group,in the control group,there was no umbilical cord wound around the neck in 200 cases,while in the observation group,there was suspected umbilical cord wound around the neck in 200 cases.Then the umbilical artery blood flow impedance value(S/D),pulsatility index(PI)and resistance index(RI)of the umbilical arteries of the two groups were compared.The diagnosis result in labor as the gold standard,the diagnostic accuracy and value of color Doppler ultrasound for abnormal fetal position were analyzed.Results S/D(3.91±0.51),RI(0.86±0.51),and PI(0.97±0.76)in the observation group were higher than those in the control group(2.54±0.32,0.13±0.05 and 0.32±0.07),the differences were statistically significant(P<0.05).The correct rate of color Doppler ultrasound diagnosis of fetal position abnormalities was 95.92%(47/49),and the difference between the diagnosis by color ultrasound and the diagnosis in labor was not statistically significant(P>0.05).At the same time,200 cases were suspected to have umbilical cord around the neck.There were 182 cases diagnosed in the mid-production.The sensitivity of color ultrasound to the diagnosis of late pregnancy was 98.90%,the specificity was 94.44%,the missed diagnosis rate was 1.10%,and the misdiagnosis rate was 5.56%.Conclusion In the diagnosis of fetal edema around the neck in the third trimester of pregnancy,color Doppler ultrasound examination is also needed,which improves the diagnostic accuracy and provides a reliable basis for the choice of delivery mode.