论文部分内容阅读
目的探讨脐带绕颈的分娩方式对围产儿预后的影响。方法收集2005年10月-2006年10月间来我院住院分娩者临床资料,按是否有脐带绕颈分组,统计比较脐带绕颈对胎儿宫内窘迫发生率、新生儿窒息情况及分娩方式。据脐带绕颈诊断时间,分析产前、产时诊断对分娩方式与胎儿宫内窘迫发生率的影响。结果脐带绕颈组头位、臀位的剖宫产率均显著高于非绕颈组(头位P<0.01,臀位P=0.01),胎儿宫内窘迫率显著高于非绕颈组(P<0.05),两组新生儿窒息率无显著差异(P>0.05)。在181例脐带绕颈病例中,产前诊断者与产时诊断者分娩方式差异有统计学意义(P<0.05),前者剖宫产率显著高于后者,胎儿宫内窘迫率后者显著高于前者(P<0.01)。脐带长度<30cm时不容易发生脐带绕颈,脐带长度>70cm时发生脐带绕颈的危险性显著增加(P<0.01)。结论脐带绕颈可使胎儿宫内窘迫率及剖宫产率增高,产前诊断脐带绕颈有助于降低胎儿宫内窘迫率,同时还对分娩方式产生影响。脐带绕颈发生率随脐带长度增加而显著升高。应通过规范产检,在孕期发现脐带绕颈,使医患双方对分娩结局有个正确的认识,以降低胎儿宫内窘迫发生率。
Objective To investigate the effects of umbilical cord delivery around the neck on the prognosis of perinatal children. Methods The clinical data of hospitalized delivery from October 2005 to October 2006 were collected. According to whether there were umbilical cord around the neck, the incidence of fetal distress, neonatal asphyxia and mode of delivery were compared statistically. According to the umbilical cord around the neck diagnosis time, analysis of prenatal and postnatal diagnosis of mode of delivery and the impact of fetal distress. Results The cesarean section rate of umbilical cord around neck group was significantly higher than that of non-neck group (head position P <0.01, breech position P = 0.01), fetal distress rate was significantly higher than that of non-neck neck group P <0.05), no significant difference in neonatal asphyxia between the two groups (P> 0.05). Among the 181 cases of umbilical cord around the neck, there was significant difference in the mode of delivery between the prenatal diagnosis and the diagnosis during delivery (P <0.05). The former had a significantly higher rate of cesarean section than the latter, and the latter was significantly higher Higher than the former (P <0.01). The umbilical cord around the neck is not easy to occur when the length of the umbilical cord is less than 30cm. The risk of the umbilical cord around the neck increases when the umbilical cord length is> 70cm (P <0.01). Conclusion Umbilical cord around the neck can make fetal distress rate and cesarean section rate increased, prenatal diagnosis of umbilical cord around the neck helps to reduce the rate of fetal distress, but also on the mode of delivery have an impact. The incidence of cord around the neck with the cord length increased significantly increased. Should pass the standardized childbirth, in the pregnancy found around the neck cord, so that both doctors and patients have a correct understanding of the delivery endings to reduce the incidence of fetal distress.