妊娠晚期脐带过度扭转的临床观察与处理

Clinical observation and treatment of excessive torsion of umbilical cord in late pregnancy

目的探讨妊娠晚期脐带过度扭转的临床观察与处理。方法选取2892例分娩产妇,将发生脐带过度扭转的103例产妇设为研究组;另选取同期无并发症正常分娩的产妇110例设为对照组。比较两组分娩孕周、分娩方式及围生儿情况。结果研究组分娩孕周<37周占比显著高于对照组,孕周37~40周分娩占比显著低于对照组,差异有统计学意义(P<0.05)。研究组剖宫产率及产钳助产率显著高于对照组,差异有统计学意义(P<0.05)。研究组顺产率15.53%低于对照组的67.27%,差异有统计学意义(P<0.05)。研究组胎儿宫内窘迫、新生儿窒息、宫内生长受限占比均高于对照组,差异有统计学意义(P<0.05)。结论妊娠晚期脐带过度扭转的发生增加围生儿不良结局的发生率,会改变孕妇分娩方式,医疗部门和卫生机构应该加强科普,提高公众对脐带过度扭转的认知,并自我监测、按时产检,及时采取有效干预措施,从而减少不良妊娠结局的发生,保障母婴安全。

Objective To investigate the clinical observation and treatment of excessive torsion of umbilical cord in late pregnancy.Methods 2892 parturients were selected,and 103 parturients with excessive torsion of umbilical cord were selected as study group.Another 11o cases of normal delivery without complications were selected as the control group.The gestational age,delivery mode and perinatal condition of the two groups were compared.Results The proportion of delivery at age<37 weeks in the study group was significantly higher than that in the control group,and the proportion at age 37-40 weeks was significantly lower than that in the control group,with statistical significance(P<0.05).The cesarean section rate and forceps assisted delivery rate of the study group were significantly higher than those of the control group,with statistical significance(P<0.05).The vaginal delivery rate of the study group was 15.53%lower than that of the control group(67.27%),and the difference was statistically significant(P<o.05).The proportion of fetal distress,neonatal asphyxia and intrauterine growth restriction in the study group was higher than that in the control group,and the difference was statistically significant(P<o.o05).Conclusion The occurrence of excessive torsion of umbilical cord in the third trimester of pregnancy increases the incidence of perinatal adverse outcomes and changes the way of delivery of pregnant women.Medical departments and health institutions should strengthen science popularization,improve the public's awareness of excessive torsion of umbilical cord,self-monitor,timely delivery check-up,and take effective intervention measures in a timely manner,so as to reduce the occurrence of adverse pregnancy outcomes and ensure the safety of mother and child.