| Background and ObjectivePerinatal asphyxia is a pathological mechanism in which blood flow between the fetal placenta is blocked or interrupted,resulting in hypoxia or acidosis,which can cause serious adverse consequences for perinatal children[1].Fetal distress is a common serious complication in clinical obstetrics.It occurs mainly because the fetus suffers from hypoxia or asphyxia in the uterus.Long-term intrauterine hypoxia may exceed the fetal tolerance to hypoxia.So that the body is not enough to compensate for the effects of hypoxia or asphyxia,resulting in serious damage to vital organs such as the brain,heart and kidneys.There are many risk factors in pregnancy that can lead to the occurrence of adverse pregnancy outcomes.In recent years,research on the influence of placenta and umbilical cord factors on fetal outcomes has become a hot topic,especially the research on umbilical cord factors has attracted more and more attention from the society.The umbilical cord is the only channel for life support for the fetus,so there is a certain protective mechanism for the umbilical cord in the fetal body.For example,the production of amniotic fluid can buffer the pressure of the uterus contraction on the umbilical cord,and the anatomical structure and tissue structure of the umbilical cord also play a certain role in the umbilical cord.Protection.When these mechanisms are broken,the fetus may be at risk,leading to adverse pregnancy outcomes such as perinatal encephalopathy or death[2].With the development of prenatal diagnostic techniques for the fetus,the perinatal morbidity and mortality caused by fetal abnormalities in the early and middle stages of pregnancy decreased,while the perinatal morbidity and mortality of umbilical cord factors gradually increased[3].Doppler ultrasonography during pregnancy for prenatal testing,strengthen the management of the fetus with umbilical cord abnormalities and increase the number of prenatal examinations,be alert to the occurrence of fetal hypoxia or asphyxia,reduce the morbidity and death of perinatal infants.rate.The purpose of this paper is to analyze and compare the perinatal outcomes of hospitalization and umbilical cord abnormalities in the Second Affiliated Hospital of Zhengzhou University,to explore the potential risk of maternal delivery in abnormal umbilical cord,to guide clinicians to choose the appropriate mode of delivery,and to reduce the incidence of adverse pregnancy outcomes in perinatalMaterials and Methods1 MaterialsRetrospectively collected in January 2017-January 2019 to the Second Affiliated Hospital of Zhengzhou University hospital delivery merger umbilical cord abnormalities as 241 cases of pregnant women with abnormal umbilical cord.The 250 pregnant women with no umbilical cord abnormalities were collected as the control group at the same time.All the subjects were single-born pregnant women and there was no gestational comorbidity.2 MethodsAll maternal women underwent fetal system Doppler ultrasonography at prenatal intervals,and electronic fetal monitoring was performed after 32 weeks of gestation.The sex,weight,water status of the sheep,umbilical cord,and mode of delivery were recorded during childbirth,and the newborns were evaluated by Apgar score and umbilical arterial blood gas analysis.3 Statistic AnalysisSPSS 19.0 statistical software was used to analyze all the research data,in which the measurement data were expressed by mean±standard deviation（?x±s）,and the independent sample t test was used to compare the two groups;the utilization rate or composition ratio of the counting data was described by n（%）and the chi-square test was used to compare the two groups.All the results showed that P<0.05 had statistical significance and the test level was a=0.05.Results1 General informationThe general data of all subjects were compared.There were no significant differences in maternal age,gestational age,parity,neonatal gender and body weight（P>0.05）.2 Classification of umbilical cord abnormalitiesIn the umbilical cord abnormal group,umbilical cord entanglement accounted for 56.02%（135/241）,umbilical cord torsion accounted for 19.09%（46/241）,umbilical cord recessive prolapse accounted for 9.54%（23/241）,umbilical cord true contraction Accounted for 2.90%（7/241）,sail-shaped placenta accounted for about4.15%（10/241）,racquet-like placenta accounted for about 8.29%（20/241）,of which the incidence of umbilical cord entanglement is higher,the umbilical cord is the most common.3 Comparison of maternal delivery methods between the two groupsThe mode of delivery of the two groups of pregnant women was compared.The vaginal delivery rate of the umbilical cord abnormal group was significantly lower than that of the control group.The cesarean section rate was significantly higher than that of the control group,and the results were statistically significant（P<0.05）.4 Comparison of maternal electronic fetal monitoring test results in two groupsThe electronic fetal monitoring results of the two groups of pregnant women were compared.The incidence of electronic fetal monitoring abnormalities in the umbilical cord abnormal group was higher than that in the control group,and the results were statistically significant（P<0.05）.5 Comparison of PH values of fetal umbilical arterial blood in maternal gestational ageThe detection results of fetal umbilical arterial blood pH in maternal gestational age were compared.The incidence of fetal umbilical arterial blood pH<7.20 in the umbilical cord abnormal group was higher than that in the control group.The results were statistically significant（P<0.05）.6 Comparison of maternal perinatal outcomes between the two groupsThe outcomes of maternal perinatal infants were compared between the two groups.The incidence of fetal distress in the umbilical cord abnormal group was higher than that in the control group.The incidence of neonatal asphyxia was higher than that in the control group,and the results were statistically significant（P<0.05）.Among them,fetal distress caused by umbilical cord entanglement accounted for 11.11%（15/135）,neonatal asphyxia accounted for about 2.96%（4/135）,fetal distress caused by umbilical cord torsion accounted for 28.26%（13/46）,and neonatal asphyxia occurred.Accounted for 10.87%（5/46）,fetal distress in the umbilical cord recessive prolapse accounted for 47.83%（11/23）,neonatal asphyxia occurred about 30.43%（7/23）,umbilical cord true knot occurred fetal distress accounted for about 42.86%（3/7）,neonatal asphyxia accounted for 14.29%（1/7）,fetal distress in racquet-like placenta accounted for about 45%（9/20）,neonatal asphyxia occurred about 10%（2/20）Fetal distress in the sail-shaped placenta accounts for about 60%（6/10）,and neonatal asphyxia accounts for about40%（4/10）.7 Comparison of prenatal color ultrasound test results for perinatal outcomesAll pregnant women were tested by color Doppler ultrasound before delivery.In the umbilical cord abnormal group,129 cases were detected with umbilical cord entanglement,9 cases were sail-shaped placenta,and 18 cases were racquet-shaped placenta.Among them,abnormal umbilical cord was found by prenatal color Doppler ultrasound test,and fetal distress occurred.About 9.54%（23/241）,neonatal asphyxia accounted for about 2.07%（5/241）;no abnormalities in the umbilical cord were detected by color Doppler ultrasound,and fetal distress occurred about 14.11%（34/241）.Childhood asphyxia accounted for approximately 7.47%（18/241）;the outcome of perinatal outcomes with prenatal umbilical cord abnormalities was compared with the outcome of no perinatal umbilical cord abnormalities,and the incidence of fetal distress and neonatal asphyxia was found in prenatal umbilical cord abnormalities.The results were statistically significant（P<0.05）.Conclusions1.Abnormal umbilical cord is easy to cause fetal distress and neonatal asphyxia,which improves the cesarean section rate of pregnant women.Abnormal umbilical cord increases the risk of fetal metabolic acidosis,which may be related to the occurrence of neonatal hypoxic ischemic encephalopathy or brain injury.2.Prenatal color Doppler ultrasound and electronic fetal monitoring have certain monitoring value for pregnant women with abnormal umbilical cord.For pregnant women with abnormal umbilical cord,strengthen prenatal antenatal color Doppler ultrasound and electronic fetal monitoring,comprehensively assess the potential risks of childbirth,and detect umbilical cord abnormalities early.The fetal hypoxia or asphyxia,choose the appropriate way to terminate the pregnancy,reduce the occurrence of adverse pregnancy outcomes in perinatal.3.The umbilical cord recessive prolapse and the sail-shaped placenta are easy to cause acute hypoxia,asphyxia and sudden death in the fetus at birth,which is harmful to perinatal children.Timely selection of cesarean section to terminate pregnancy and reduce the occurrence of adverse pregnancy outcomes in perinatal children. |
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