脐带缠绕可否成为剖宫产手术指征探讨(附200例临床分析)

目的 :探讨脐带缠绕在分娩中的风险性和并发症 ,及如何权衡利弊选择最佳分娩方式以最大可能保障母婴安全。方法 :比较 2 0 0例产后证实为脐带缠绕 (缠绕组 )和 170例无脐带缠绕的正常足月妊娠妇女 (对照组 )的围产儿监护情况及围产儿结局。结果 :缠绕组胎儿窘迫发生率显著高于对照组 (P <0 .0 0 5 ) ,发病风险随缠绕周数的增加而增加。而两组新生儿窒息率和死亡率无显著性差异 (P >0 .1) ,缠绕组急诊剖宫产率明显升高 (P <0 .0 1)。结论 :脐带缠绕患者产时风险性显著增加 ,加强产前产时胎儿监护十分重要。必要时应放宽剖宫产手术指征

COULD UMBILICAL CORD ENTANGLEMENT BECOME AN OPERATING INDICATION OF CESAREAN SECTION:CLINICAL ANALYSIS OF 200 CASES

Objective:To detective the risk factors and complications of umbilical cord entanglment during delivery,and how to choose the best way to ensure maternal and infant safety.Methods:Two groups were compared on perinatal fetal heart rate monitoring and prerinatal fetus outcomes.200 cases were randomly selected with umbilical cord entanglement which were verified after labor (entanglement group),170 controls were randomly selected at the same time(control group).Results:The incidence of fetal distress in entanglement group was significantly higher (P<0.005).The risks increased with the increasing numbers of cord entanglement.There was no difference in the incidence of neonatal asphyxia rate and neonatal mortality between the two groups (P>0.1).The incidence of emergency section in entanglement group increased significantly (P<0.01).Conclusion:The patients with umbilical cord entanglement is associated with increased risks at labor.It is important for perinatal fetus to be taken under proper intensive care.Cesarean section should be performed if necessary.