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胎儿脐带绕颈是妊娠常见的并发症,约占妊娠总数的30％左右,在分娩前准确判断有无脐带绕颈,为临床医师观察产程、分娩方式及分娩时机的选择提供了可靠依据,对提高围产儿生存率和优生率具有重要意义。 本文总结了我院自1998年12月至2000年3月在我院行产前检查并最终分娩的230例孕妇,孕38周以后B超诊断胎儿脐带绕颈者65例,分娩后证实胎儿脐带绕颈者62例。具体方法如下。 使用德国产西门子SI—400型超声诊断仪,探头频率3.5MHz,产妇仰卧位,常规探查胎儿全貌后,重点沿胎儿脊柱纵向扫查,找到胎儿颈背部皮肤绒线,观察是否有压痕,呈现“U”形压痛则诊断脐带绕颈一周;呈现“W”形压痕者为脐带绕颈两周;呈现三个以上凹形压痕者为脐带绕颈三周及三周以上。有时皮肤线压痕不明显,可横向扫查颈部皮缘外侧,见线状强回声分层排列,或呈“品”字形结构,提示脐带绕颈。
Fetal umbilical cord around the neck is a common pregnancy complications, accounting for about 30% of the total number of pregnancies before delivery accurately determine whether the umbilical cord around the neck for clinicians to observe the delivery process, delivery methods and delivery timing to provide a reliable basis for Improve perinatal survival and eugenics rate is of great significance. This article summarizes our hospital from December 1998 to March 2000 in our hospital prenatal examination and the final delivery of 230 pregnant women, 38 weeks after the pregnancy B-ultrasound diagnosis of fetal cord around the neck in 65 cases, confirmed after delivery of fetal umbilical cord 62 cases around the neck. Specific methods are as follows. Siemens Germany SI-400-based ultrasonic diagnostic apparatus, the probe frequency 3.5MHz, maternal supine position, the general exploration of the fetus after the whole picture, the focus along the fetal spine longitudinal scan to find the fetus neck and back skin velvet to see if there is indentation, showing “ U ”-shaped tenderness diagnosis of umbilical cord around the neck for a week; showing“ W ”-shaped indentation around the neck for two weeks; showing more than three concave indentation for the cord around the neck for three weeks and more than three weeks. Sometimes the skin line indentation is not obvious, lateral scan of the outer edge of the neck skin, see the linear arrangement of strong echo layered, or “goods” shaped structure, suggesting that the umbilical cord around the neck.