超声诊断胎儿脐带绕颈的应用分析

目的探讨分析超声检查在诊断胎儿脐带绕颈的中的应用价值。方法对1082例在本院分娩的、妊娠晚期36-41周的孕妇进行二维和彩色多普勒超声检查,观察胎儿颈部压迹深度、脐带绕颈周数,检测脐动脉S/D比值,并将产前超声诊断为脐带绕颈与产后临床诊断为脐带绕颈的病例进行对比分析。结果本组病例产前经超声检查诊断为胎儿脐带绕颈307例,产后临床诊断为脐带绕颈者311例,诊断符合率为97.7%,误诊3例,漏诊7例。47例脐动脉S/D比值〉3,存在不同程度宫内窘迫现象。结论二维超声与彩色多普勒相结合检查胎儿脐带绕颈特异性强、准确率高,且能够实时观察胎动及胎心搏动情况,是目前产前诊断胎儿脐带绕颈的最佳方法,为临床选择正确的分娩方式提供了可靠的依据。

An analysis of the application of ultrasonography in the diagnosis of umbilical cord around the neck

Objective To explore the application value of ultrasonography in the diagnosis of umbilical cord around the neck. Methods 1082 pregnant women who delivered in our hospital or were at the third trimester of their pregnancy（week 36 to 41） were examined via two-dimensional and color Doppler ultrasonography.Depth of neck pressure traces and number of circles of umbilical cord around the neck were observed,and S/D value of umbilical artery was tested.Patients diagnosed as umbilical cord around the neck before delivery and those diagnosed after delivery were analyzed and compared. Results 307 patients were diagnosed as umbilical cord around the neck before delivery via ultrasonography,and 311 patients were diagnosed as umbilical cord around the neck after delivery.Diagnosis accordance rate was 97.7%,with 3 misdiagnosis and 7 missed diagnosis.47 patients showed S/D value of umbilical artery〉 3,and different degrees of fetal distress were detected. Conclusion The combination of twodimensional and color Doppler ultrasonography in the diagnosis of umbilical cord around the neck has a strong specificity and high accuracy,and is able to observe fetal movement and fetal heart beat in real time, which is an optimal method of diagnosing umbilical cord around the neck for the time being and provides reliable proofs for correct delivery mode clinically.