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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。临床处理主要根据胎儿的存活及宫口开大的情况尽快结束分娩
Objective: To investigate the effect of head umbilical cord prolapse on perinatal children, clinical manifestations, diagnosis and treatment. Methods: The clinical data of 18 cases of umbilical cord prolapse in our hospital during 10 years were retrospectively analyzed. Results: The head umbilical cord prolapse accounted for 72% of the total umbilical cord prolapse, clinical abnormalities showed fetal heart rate, type Ⅰ showed early fetal distress, timely termination of pregnancy, good fetal prognosis; type Ⅱ, Ⅲ fetal distress Of the serious performance, timely termination of pregnancy, the fetus is still the time to rescue success; type Ⅳ for the performance of the dying of the fetus, the mortality rate is extremely high, the prognosis is poor. Perinatal mortality was 2 7.8%. CONCLUSION: Head umbilical cord prolapse is extremely harmful to perinatal patients. The early clinical manifestations are subtle, which is mainly manifested in abnormal fetal heart rate monitoring. Fetal heart monitoring and B- help early detection of umbilical cord prolapse. The key is to prevent the fetal head floating high timely rupture of the guardianship and treatment. Clinical treatment mainly based on the survival of the fetus and cervix open situation as soon as possible end of childbirth