摘要
目的评估孕早期超声监测脐带附着部位的可行性,研究孕早期脐带附着于子宫下1/3段与围产期并发症之间的相关性。方法选择孕11~14周进行胎儿颈后透明带检查并在我院分娩的孕妇302例,用彩色多普勒超声检查脐带入口(CI),目测脐带入口位于子宫下1/3段的列为低CI组,脐带入口位于子宫中、上1/3段的列为正常CI组。孕28~32周再次行超声检查是否存在前置胎盘、帆状胎盘、前置血管等胎盘、脐带异常。孕期严密随访至分娩,并于分娩或剖宫产后检查胎盘,观察是否存在胎盘、脐带异常。结果 302例孕妇中,低CI组50例,正常CI组252例。低CI组前置胎盘、脐带附着异常(脐带帆状附着、脐带边缘附着)、胎盘畸形(副胎盘、双叶胎盘)、产时胎心异常、新生儿低Apgar评分、急诊剖宫产的发生率明显高于正常CI组,两组比较差异有统计学意义(P<0.05),提示孕早期脐带入口位于子宫下1/3段者胎盘脐带附着异常、胎盘脐带畸形以及围产期并发症的发生率较高。结论孕早期脐带附着于子宫下1/3段与胎盘及脐带发育异常具有相关性,在孕11~14周进行脐带入口的确定对筛查胎盘与脐带异常具有很大的临床意义。
Objective To assess the feasibility of application of ultrasound in monitoring the umbilical CI （Cord Insertion） site during the first trimester, and to investigate the possible relevance between perinatal complications and the umbilical cord inserted in the 1/3 lower uterine segment in early pregnancy. Methods Altogether 302 pregnancies who accepted NT （Nuchal Translucency） scans at the 11th to 14~ weeks of gestation and delivered in the hospital were selected. Scanned by color Doppler ultrasound, the pregnancies whose CI was located in 1/3 lower uterine segment were defined as Low CI Group; pregnancies whose CI was located in the middle or I/3 upper uterine segment were defined as Normal CI Group. In all the cases, precise ultrasound assessments were required during pregnancies at the 28^-32nd weeks of gestation so as to detect the abnormalities of the placenta and umbilical cord, such as placenta previa, velamentous placenta and vasa praevia. All the cases were followed up until delivery and accepted the pathological examinations to observe the abnormalities of the placenta and umbilical cord after delivery or cesarean section. Results Among 302 cases of pregnancies, there were 50 cases in Low CI Group and 252 cases in Normal CI Group. The occurrence rates of placenta previa, abnormal CI （velamentous or marginal CI）, placental malformation （accessory or bilobate placenta）, abnormal intrapartmn FHR （Fetal Heart Rate）, low Apgar scores as well as emergency cesarean section in Low CI Group were higher than those of Normal CI Group with statistically significant differences （P〈0.05）, which indicated the higher incidence rate of abnormal CI, placental and umbilical cord malformation as well as perinatal complications in CI located in the 1/3 lower uterine segment in the first trimester. Conclusion Developmental abnormalities of the placenta and umbilical cord had relevance with the CI located in the 1/3 lower uterine segment in the first trimester. Screening for the cord insertion site at
出处
《中国医疗设备》
2015年第8期35-38,共4页
China Medical Devices
关键词
脐带附着部位
超声监测
脐带入口
胎盘异常
脐带异常
umbilical cord insertion sites
ultrasonic monitoring
umbilical cord insertion
placental abnormality
umbilical cord abnormality
