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目的急性胎儿宫内窘迫是导致围产儿死亡的主要原因,大多系胎盘及脐带因素导致胎儿缺氧所致。通过检测晚期正常妊娠及急性胎儿宫内窘迫的胎盘表达神经轴突导向因子-1(neuron towards axon guidance factor-1,Netrin-1)水平、相应脐带情况及患者娩出新生儿出生状况,从而探讨Netrin-1在急性胎儿宫内窘迫中发病的可能机制。方法选取2012年10月1日—2013年9月30日间剖宫产终止妊娠孕妇共27例。其中15例正常足月妊娠孕妇为对照组,12例急性胎儿宫内窘迫患者为研究组。检测所有入选病例胎盘中Netrin-1表达水平,观察2组胎儿娩出时脐带情况,测定相应新生儿出生体重及出生后1 min Apgar评分。结果 2组患者胎盘Netrin-1表达水平、新生儿出生体重及出生后1 min Apgar评分差异均无统计学意义(P>0.05)。对照组未见明显脐带异常。12例胎儿宫内窘迫10例存在脐带绕颈,1例脐带螺旋。10例脐带绕颈中3例脐带绕颈两周;7例脐带绕颈1周,脐带绕颈1周新生儿患者中3例存在脐带水肿。但所有娩出胎盘均未见明显异常。与对照组相比,急性胎儿宫内窘迫组脐带异常明显(P<0.05)。结论 Netrin-1在急性胎儿宫内窘迫胎盘维持功能过程中作用较小。孕晚期急性胎儿宫内窘迫发生多因脐带因素所致。
Objective Acute fetal distress is the leading cause of perinatal death, mostly due to placenta and umbilical cord factors leading to fetal hypoxia. To detect the expression of neuron towards axon guidance factor-1 (Netrin-1) in the placenta of patients with advanced normal pregnancy and acute fetal distress, the corresponding umbilical cord conditions and the birth of newborn infants -1 in acute fetal distress in the pathogenesis of possible mechanisms. Methods A total of 27 pregnant women with cesarean termination were selected from October 1, 2012 to September 30, 2013. 15 cases of normal term pregnant women as the control group, 12 cases of acute fetal distress in the study group. The placenta Netrin-1 expression was detected in all the selected cases. The umbilical cord of the two groups was observed. The birth weight and Apgar score at 1 minute after birth were measured. Results There was no significant difference in Netrin-1 expression, neonatal birth weight and Apgar score at 1 minute after birth between the two groups (P> 0.05). The control group showed no obvious umbilical cord abnormalities. 12 cases of fetal distress in 10 cases there umbilical cord around the neck, ugg outlet, 1 case of umbilical cord spiral. 10 cases of umbilical cord around the neck in 3 cases around the neck around the neck for two weeks; 7 cases of umbilical cord around the neck for 1 week, umbilical cord around the neck 1 week in neonatal 3 patients with umbilical cord edema. But all the placenta did not show obvious abnormalities. Compared with the control group, the umbilical cord in the acute fetal distress group was significantly abnormal (P <0.05). Conclusion Netrin-1 plays a minor role in placental maintenance during acute fetal distress. The third trimester of pregnancy due to fetal distress caused by umbilical cord factors.