妊娠晚期胎儿脐带绕颈的联合监护情况分析

目的:探讨胎儿脐带绕颈的孕妇妊娠晚期应用彩超、脐血流速度测定和胎心无负荷试验联合监护,判断胎儿预后的价值。方法:应用彩超确诊为胎儿脐带绕颈并测定脐动脉血流速度S/D值和胎心无负荷试验NST ,比较分析2 13例胎儿脐带绕颈孕妇(观察组)和2 2 0例无胎儿脐带绕颈孕妇(对照组)妊娠晚期情况。结果:观察组NST无反应型、可疑型或S/D值≥3发生率,比对照组明显增高(P <0 . 0 1) ,胎儿宫内窘迫和剖宫产发生率明显增高(P <0 .0 1) ,但两组新生儿重度窒息发生率无显著性差异(P >0 . 0 5 )。结论:脐血流参数测定S/D值与胎心NST联合应用,可以提高脐带绕颈胎儿宫内缺氧状态的诊断,为临床及时纠正宫内缺氧和选择分娩方式提供可靠依据

The Combined Monitor Analysis of Cord around Neck in Late Pregnancy

Objective: To discuss the value of combined instrumental monitor, including color Doppler echocardiography, systolic-diastolic ratio and non-stress test, for judging fetal Prognosis in late Pregnancy.Methods: Fetal non-stress test NST and systolic-diastolic ratio(S/D) combined with fetal umbilical artery Doppler echocardiography were used in comparing the 213 pregnant women with cord around neck (group A) to 220 ones without it(group B). Results:The incidence of systolic-diastolic ratio(S/D)≥3 of the suspicious and non-reactive NST types in the group A is significantly higher than that in the group B(P<0.01), and that of fetal distress and cesarean section was higher too(P<0.01). But the incidence of their deep asphyxia is not significantly high(P>0.05). Conclusions: The combined application of systolic-diastolic ratio(S/D) and fetal non-stress test(NST) can advance the diagnosis of the fetal anoxia which are cord around neck. Some more accurate evidence will be provided to correct the fetal anoxia and choose the way of childbirth.