帆状胎盘前置血管破裂:可避免的围产儿死亡

目的 探讨帆状胎盘的临床特点，对围产儿的影响，以及早期诊断、正确处理的方法，以降低围产儿死亡率。方法 回顾性分析1999年1月-2006年6月102例帆状胎盘及帆状胎盘前置血管破裂的病例，将其与同期37474例非帆状胎盘病例进行比较。结果 帆状胎盘发生率为0.27％。帆状胎盘前置血管破裂发生率为0．016％。帆状胎盘组中多胎（13．7％）、前置胎盘（9、8％）、胎盘早剥（3．9％）、早产（26．5％）、单脐动脉（2．56％）、低出生体重儿（29．05％）、新生儿窒息（14．52％）、新生儿死亡（11.1％）、死胎（2．56％）的发生率与对照组比较有极显著性差异。帆状胎盘前置血管破裂围产儿死亡率高达100％。结论 帆状胎盘前置血管是严重威胁围产儿安全的疾病，利用现代超声技术在产前作出正确诊断是降低围产儿死亡率的关键。

Vasa previa:An avoidable perinatal death

Objective:To explore the clinical feature of velamentous umbilical cord insertion,the influence to perinatal outcome,the method of prenatal diagnosis and management and to prevent perinatal death.Methods:Retrospectively reviewed 102 cases of velamentous umbilical cord insertion and vasa previa from Jan 1999 to Jun 2006,whereas the remaining 37474 were normal controls.Results:The incidence of velamentous umbilical cord insertion was 0.27%,and the incidence of vasa previa was 0.016%.Velamentous umbilical cord insertion was associated with high risk of multiple pregnancy(13.7%),placenta previa(9.8%),placental abruption(3.9%),preterm birth(26.5%),single umbilical artery(2.56%),low birth weight(29.05%),low Apgar scores(14.52%),neonatal death(11.1%),still birth(2.56%).The perinatal mortality of vasa previa approached 100%.Conclusion:Velamentous umbilical cord insertion is associated with high prevalence of perinatal mortality,the key to a good outcome lies in prenatal sonographic diagnosis.