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目的通过对单脐动脉(SUA)的产科临床病例进行分析,进一步提高临床对单脐动脉的诊断和处理水平。方法回顾分析在我院分娩并诊断的37例单脐动脉病例,在同期无妊娠合并症及并发症的足月单胎非单脐动脉病例中随机选取37例做对照,分析SUA的妊娠结局、产前超声检查、S/D比值变化及胎心电子监护情况。结果在15793次分娩中发现单脐动脉37例,发生率为0.23%。其中单纯性单脐动脉24例,发生率为64.86%;合并其他超声异常的单脐动脉13例,发生率35.14%。产前超声检查32例,诊断符合率90.62%;出生缺陷8例,发生率21.62%。FGR8例,发生率21.62%;产前诊断28例,染色体异常发生率为3.57%;早产4例,发生率12.5%;死胎3例,围产儿死亡率8.10%;单脐动脉的出生缺陷、FGR、胎儿窘迫、S/D比值异常升高发生率及胎心电子监护异常发生率明显高于非单脐动脉,差异有统计学意义(P<0.05),新生儿窒息及围产儿死亡发生率无明显统计学差异(P>0.05)。结论单脐动脉有较高的新生儿出生缺陷、FGR、胎儿窘迫、早产及围产儿死亡发生率。大部分单脐动脉胎儿结局良好,产前超声检查发现单脐动脉应仔细检查胎儿的各个系统有无形态、结构异常,对继续妊娠的病例应动态监测胎儿宫内发育情况,加强产前、产时的监测。
Objective To further improve the clinical diagnosis and treatment of single umbilical artery through the analysis of obstetric clinical cases of single umbilical artery (SUA). Methods Retrospective analysis of 37 cases of single umbilical artery in our hospital and diagnosis of cases of non-pregnancy complications and complications in the same period of unilateral single non-umbilical artery were randomly selected 37 cases of control, analysis of SUA pregnancy outcome, Prenatal ultrasound, S / D ratio changes and fetal heart monitoring. Results In 15 793 deliveries, 37 cases of single umbilical artery were found, the incidence was 0.23%. Including simple unilateral umbilical artery in 24 cases, the incidence was 64.86%; with other ultrasonic abnormalities in 13 cases of single umbilical cord, the incidence of 35.14%. Prenatal ultrasound examination in 32 cases, the diagnostic coincidence rate of 90.62%; birth defects in 8 cases, the incidence of 21.62%. FGR 8 cases, the incidence of 21.62%; prenatal diagnosis of 28 cases, the incidence of chromosomal abnormalities was 3.57%; premature birth in 4 cases, the incidence rate of 12.5%; 3 cases of stillbirth, perinatal mortality rate 8.10%; single umbilical artery birth defects, FGR , The incidence of fetal distress, abnormal S / D ratio and abnormal fetal heart rate were significantly higher than those of non-umbilical artery (P <0.05). The incidence of neonatal asphyxia and perinatal death was Significant statistical difference (P> 0.05). Conclusions Single umbilical arteries have a high incidence of neonatal birth defects, FGR, fetal distress, premature birth and perinatal mortality. Most single umbilical artery fetuses have a good outcome. Prenatal ultrasound examination revealed that the umbilical arteries of the fetus should be carefully examined for the presence or absence of various morphological and structural abnormalities in the fetus. Dynamic monitoring of intrauterine growth should be performed in cases of continued pregnancy, When monitoring.