| 摘要: |
| 目的 分析脐动脉闭塞合并脐带过度扭转的产前超声特征及其妊娠结局。方法 选取我院确诊的脐动脉闭塞合并脐带过度扭转胎儿6例，分析其一般情况、产前超声特征、妊娠结局、脐带病理检查资料。结果 产前超声特征：6例胎儿既往均为两条正常脐动脉，而后一条脐动脉发生闭塞且脐带过度扭转；脐动脉闭塞前胎儿超声孕周均符合临床孕周，闭塞后有3例超声孕周小于临床孕周；5例胎盘增厚，1例羊水过多；所有胎儿大脑中动脉搏动指数（MCA-PI）、脐动脉搏动指数（UA-PI）均较正常参考值减低，脐动脉收缩期与舒张期峰值流速比值（UA-S/D）较正常参考值相比未见异常。妊娠结局：6例胎儿中，胎死宫内1例，活产儿5例，5例胎儿均因出现胎心监护异常剖宫产分娩。5例活产儿中，其中3例早产，4例为低出生体质量儿，2例为小于胎龄儿。脐带病理检查：所有胎儿脐带均过度扭转且脐动脉血栓形成，死胎脐轮部变细呈索状坏死。结论 脐动脉闭塞合并脐带过度扭转时产前超声多表现为胎儿MCA-PI减低，可结合胎心监护表现积极干预，避免不良妊娠结局的发生。 |
| 关键词: 超声检查，产前 脐动脉闭塞 脐带过度扭转 妊娠结局 |
| DOI： |
| 投稿时间：2024-02-05修订日期：2024-08-15 |
| 基金项目: |
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| Prenatal ultrasound characteristics of umbilical artery occlusion combined with excessive twisting of the umbilical cord and analysis of pregnancy outcomes |
| Liang tiantian,Wu Qingqing,Li Xiaofei,Zhao Huawei,Wang Xiaoling |
| (Department of Ultrasound，Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital) |
| Abstract: |
| Purpose Analysis of prenatal ultrasound features and pregnancy outcomes of umbilical artery occlusion combined with excessive twisting of the umbilical cord.Methods Selecting 6 cases of fetuses diagnosed with umbilical artery occlusion combined with excessive twisting of the umbilical cord in our hospital, analyze their general conditions, prenatal ultrasound features, pregnancy outcomes, and umbilical cord pathology examination data.Results Prenatal ultrasound features: In the 6 cases, the fetuses all had two normal umbilical arteries in the past, but one of the arteries later became occluded and the umbilical cord experienced excessive twisting. Before the occlusion of the umbilical artery, the gestational age of the fetuses on ultrasound matched the clinical gestational age, but after occlusion, 3 cases had a gestational age on ultrasound that was less than the clinical gestational age. 5 cases had thickened placentas, and 1 case had polyhydramnios. The pulsatility index (MCA-PI) and umbilical artery pulsatility index (UA-PI) of all fetuses were lower than the normal reference values, while the umbilical artery systolic/diastolic peak velocity ratio (UA-S/D) showed no abnormalities compared to the normal reference values. Pregnancy outcomes: Among the 6 fetuses, there was one intrauterine fetal death and 5 live births. All 5 live births were delivered by cesarean section due to abnormal fetal heart monitoring. Of the 5 live births, 3 were premature, 4 had low birth weight, and 2 were small for gestational age. Umbilical cord pathology examination: All fetuses had excessively twisted umbilical cords with umbilical artery thrombosis. The umbilical cord of the stillborn fetus showed thinning and necrosis in the cord wheel area.Conclusion When umbilical artery occlusion is combined with excessive twisting of the umbilical cord, prenatal ultrasound often shows a decreased MCA-PI in the fetus. Active intervention, combined with fetal heart monitoring, can help prevent adverse pregnancy outcomes from occurring. |
| Key words: Ultrasound examination prenatal umbilical artery occlusion excessive twisting of the umbilical cord pregnancy outcome. |
