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目的探讨前置血管的临床特点、对围产儿影响及早期诊断和正确处理的方法,降低围产儿病死率。方法回顾性分析2014年4月至2016年3月在福建省妇幼保健院住院分娩发生前置血管的13例临床资料。结果前置血管发生率0.42‰(13/31 024)。13例均经产前超声诊断,产后明确诊断,其中合并脐带帆状附着10例(76.9%)、前置胎盘4例(30.8%)、胎盘异常3例(23.1%)。前置血管未破裂者11例均手术终止妊娠,其中2例胎膜早破、9例择期手术。新生儿出生时Apgar评分10分9例,9分2例;前置血管破裂的2例,1例死胎引产,1例急诊手术,新生儿失血表现明显。结论前置血管是严重威胁围产儿安全的疾病,超声检查是产前诊断的主要方法。加强妊娠高危人群筛查,提高产前诊断率和个体化治疗,是减少围产儿死亡的关键。
Objective To explore the clinical features of anterior vascular, the impact on perinatal children and early diagnosis and correct treatment methods to reduce perinatal mortality. Methods A retrospective analysis of 13 cases of pre-existing blood vessels in hospital maternity and child care in Fujian province from April 2014 to March 2016 was performed. Results The incidence of antecedent blood vessels was 0.42 ‰ (13/31 024). Thirteen cases were diagnosed by prenatal ultrasound and confirmed postpartum. Among them, 10 cases (76.9%) had umbilical cord attachment, 4 cases had placenta previa (30.8%) and 3 cases (23.1%) had abnormal placenta. Preventive blood vessels were not ruptured in 11 cases were terminated by surgery, including 2 cases of premature rupture of membranes, 9 cases of elective surgery. Neonatal Apgar score was 10 points and 9 cases in 9 cases and 2 cases. Premature rupture of blood vessels in 2 cases, 1 case of stillbirth induction, 1 case of emergency surgery, neonatal blood loss significantly. Conclusions The anterior vascular is a serious threat to perinatal safety of the disease, ultrasound is the main method of prenatal diagnosis. To strengthen the screening of pregnant women at high risk, improve the rate of prenatal diagnosis and individualized treatment, is the key to reducing perinatal death.