B超及多普勒胎儿脐血流分析仪联合诊断脐带绕颈

目的评价B超和脐血流速度分析仪联合检查在监测脐带绕颈及由其所引起的胎儿宫内安危中的价值.方法1999年3月至5月我科B超检查诊断晚期妊娠脐带绕颈86例,同时行多普勒胎儿血流分析仪监护S/D比值,并随访妊娠结局,对脐带绕颈特别是血流阻力高者提示产科医生警惕胎儿窘迫,正确处理产程.结果分娩证实脐带绕颈72例,符合率83.7%,S/D异常的11例,胎儿窘迫手术产率高于S/D正常者(P＜0.05).结论B超及多普勒胎儿脐血流分析仪联合应用可提高脐带绕颈及脐血S/D异常的诊断率,预测胎儿窘迫的发生,减少低Apgar评分儿的出生,并减少社会因素造成的剖宫产.

Diagnosis of cord entanglement by B ultrasonic combined doppler examination

Objective To evaluate diagnosis of cord entanglem ent and fetus safety by B ultra-sonic and nemodromometer. Methods 86 pregnant women were diagnosed as cord entanglement in late pregnancy by B ultrasonic examination and Doppler blood flow analysis of the S/D ratio from ma r to May, 1999. The pregnancy outcomes were followed up. Cord entanglement,es -pecially the high blood circulating resistance, suggested that there was h igh risk of fetal distress. The obstetrician would manage the delivery stage pro perly according to the results of Doppler examination.Results 7 2 women were proved cord entanglement after delivery wity coincident rate of 83. 7%. Five women were delivered by cesarean section and forceps among 11 cases of abno rmal S/D ratio, and the rate of operative delivery in group with abnormalS/D rat io was significantly higher than that of the group with normal S/D ratio (P ＜0.05). Conclusions The combined examination can improve the rate of diagnosis of cord entanglement and abnormal S/D ratio, forecast the feta l distress, reduce birth rate of infant with lower Apgar score and reduce the ces arean section rate due to social factor.