脐带脱垂的临床特征与妊娠结局分析

Analysis on clinical features and pregnancy outcomes of umbilical cord prolapse

目的探讨脐带脱垂的临床特征与妊娠结局的关系。方法选择该院2008年1月至2017年12月收治的50例脐带脱垂患者为研究对象,记录临床基本特点及妊娠结局情况,比较分娩方式与围生儿结局等情况。结果胎膜早破、早产、臀位等是脐带脱垂的高危因素。脐带脱垂患者阴道分娩、剖宫产新生儿的1 min Apgar评分分别为(1.33±1.27)、(7.55±2.87)分,5 min Apgar评分分别为(1.50±0.67)、(8.75±1.78)分,与阴道分娩比较,剖宫产能明显提高新生儿Apgar评分,二者比较差异有统计学意义(P<0.05);阴道分娩、剖宫产胎儿娩出时间(DDI)分别为(3.82±2.89)、(0.93±0.07)h,二者比较差异有统计学意义(P<0.05)。隐性脐带脱垂、显性脐带脱垂1 min Apgar评分分别为(8.65±2.52)、(5.36±3.69)分,5 min Apgar评分分别为(9.29±1.45)、(6.72±3.71)分,隐性脐带脱垂新生儿Apgar评分明显高于显性脐带脱垂,二者比较差异有统计学意义(P<0.05);隐性脐带脱垂、显性脐带脱垂DDI分别为(3.19±2.74)、(1.60±0.03)h,二者比较差异有统计学意义(P<0.05)。结论胎膜早破时需警惕脐带脱垂风险,一旦发生脐带脱垂,如胎儿存活,宜尽快剖宫产终止妊娠。

Objective To analyze the relationship between the clinical features of umbilical cord prolapse and pregnancy outcomes.Methods Fifty patients with umbilical cord prolapse admitted to this hospital from January 2008 to December 2017 were selected as the study subjects.The clinical basic characteristics and pregnancy outcomes were recorded,and the delivery mode and perinatal infant outcomes were compared.Results The premature rupture of membrane,premature delivery and breech position were the high risk factors of umbilical cord prolapse.Among the patients with umbilical cord prolapse,the 1 min Apgar scores in vaginal delivery and cesarean section were(1.33±3.27)points and(7.55±2.87)points,the 5 min Apgar scores were(1.50±3.67)points and(8.75±1.78)point.Compared with vaginal delivery,cesarean section could significantly improve newborn Apgar score,the differences between them were statistically significant(P<0.05).The fetal delivery time in the vaginal delivery and cesarean section was(3.82±2.89)h and(0.93±0.07)h,the difference between them was statistically significant(P<0.05).The 1 min Apgar scores in the recessive umbilical cord prolapse and dominant umbilical cord prolapse were(8.65±2.52)points and(5.36±3.69)points respectively,the 5 min Apgar scores were(9.29±1.45)points and(6.72±3.71)points respectively,the Apgar scores in the recessive umbilical cord prolapse was significantly higher than those in the dominant umbilical cord prolapse,and the differences between them were statistically significant(P<0.05).DDI in the recessive umbilical cord prolapse and dominant umbilical cord prolapse were(3.19±2.74)h and(1.60±0.03)h respectively,and the difference between them was statistically significant(P<0.05).Conclusion Premature rupture of membrane should be alert to the risk of umbilical cord prolapse,once the umbilical cord prolapse occurs,if fetus survives,the pregancy should be terminated by cesarean section as soon as possible.