摘要
目的 :探讨头位脐带脱垂对围产儿的影响、临床表现、诊断处理和预防措施。方法 :回顾性分析1 0年内本院 1 8例头位脐带脱垂的临床情况。结果 :头位脐带脱垂占总脐带脱垂的 72 % ,临床均表现出胎心监护异常 ,Ⅰ型显示胎儿早期宫内窘迫 ,及时终止妊娠 ,胎儿预后好 ;Ⅱ、Ⅲ型胎儿宫内窘迫的严重表现 ,及时终止妊娠 ,胎儿仍有抢救成功的时机 ;Ⅳ型为胎儿濒死的表现 ,死亡率极高 ,预后差。围产儿死亡率 2 7.8%。结论 :头位脐带脱垂对围产儿危害极大 ,早期临床表现隐蔽 ,主要表现在胎心监护异常。胎心监护及B超有助于早期发现脐带脱垂。预防的关键在于对胎头高浮者破膜时的及时监护和处理。
Objective: To investigate the effect of the umbilical cord prolapse with vertex presentation on peripartum clinical course, diagnosis and management options. Methods: Eighteen cases with umbilical cord prolapse with vertex presentation were reviewed from January 1993 to January 2003 in our hospital. Results: The morbidity of cord prolapse with vertex presentation was 72% and the fetal had a abnormal heart rate in our study. The early fetal distress could be found in abnormal typeⅠand the fetus had a well prognosis when the delivery was done immediately. There was a serous fetal distress in typeⅡand Ⅲ, and the fetal might have a normal result when the delivery was done immediately. The come out cloud threat to the fetal life in type Ⅳ and the prenatal mortality rate was 27.8%. Conclusions: The results showed that the umbilical cord prolapse with vertex presentation is a risk factor of the prenatal morbidity. It is important that the electronic cardiotocograph and ultrasound examination are performed to predict the umbilical cord prolapse in early diagnosis and management. The options of delivery should be based on the cervical dilatation and fetal survival.
出处
《青海医药杂志》
2004年第5期11-13,共3页
Qinghai Medical Journal
关键词
头位脐带脱垂
胎心监护
胎儿
围产儿
Umbilical cord prolapse
Vertex presentation
Artificial rupture of membranes
Electronic cardiotocograph
Ultrasound
