脐动脉S／D值联合胎心监护在胎儿脐带缠绕预后的临床价值

目的探讨胎儿脐血流监测与胎心监护在预测胎儿脐带缠绕妊娠结局的临床价值。方法孕晚期B超诊断为胎儿脐带绕颈的孕妇452例行胎心监护、脐血流S／D值测定，并记录分娩方式、产时羊水情况及新生儿Apgar评分。结果胎监异常同时脐血流S／D比值〉3在羊水过少发生率、胎盘功能低下发生率、胎儿窘迫发生率、羊水污染发生率、剖宫产率、新生儿窒息率均明显高于胎监及S／D比值正常的孕妇。结论对胎儿脐带缠绕孕妇联合应用胎心监护与脐血流测定，可减少新生儿窒息，改善围产儿预后具有积极的临床意义。

Application value of umbilical cord blood flow S/D ratio combined with fetal heart rate monitoring in perinatal prognosis of cord around neck

Objective To investigate the clinical value of umbilical cord blood flow S/D ratio and fetal heart rate monitoring in evaluation of fetal prognosis with cord around neck.Methods All of 452 full-term pregnant women with cord entanglement were detected fetal heart rate monitoring and umbilical artery flow velocimetry.Delivery methods,amniotic fluid and Apgar score of newborn were collected.Results The incidence of oligohydramnios,placental hypofunction,fetal distress,amniotic turbidity,Caesarean and asphyxia neonatorum increased significantly in cases of abnormal fetal heart rate monitoring and S/D ≥3.0 than cases of normal fetal heart rate monitoring and normal S/D ratio.Conclusion Detection of S/D ratio of umbilical cord blood flow combined with fetal heart rate monitoring can inspect perinatal fetal hypoxia and decelerate neonatal asphyxia,improve the fetal prognosis with cord around neck.